MCKENIZE MEMORIAL HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MCKENIZE MEMORIAL HOSPITAL (EIN 38-1738615)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-04-11
- IRS object ID
- 201831019349300613
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-04-11T10:24:00-06:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381738615 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | MCKENZIE HEALTH SYSTEM | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % STEVE BARNETT | InCareOfNm |
| Business Name Control | MCKE | BusinessNameControlTxt |
| Phone | 8106483770 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVE BARNETT | PersonNm |
| Person Title | PRESIDENTCEO | PersonTitleTxt |
| Phone | 8106486171 | PhoneNum |
| Signature | 2018-04-11 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 192.30.159.164 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 21010520181019914396 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-04-11 | FederalOriginalSubmissionIdDt |
| Filing License Type | O | FilingLicenseTypeCd |
| At Submission Creation Device Id | 620F957C4DAE88EA7D0B2BCD00B9DB78168AFEBC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6BC8D78C6B97D019391E92741AD08EBD8A1CCFD6 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE BARNETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,000,308 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCKENZIEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | FOUNDED AS A COMMUNITY HOSPITAL MCKENZIE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT COMPASSIONATE AND ESSENTIAL HEALTHCARE | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 297 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $32,339 | TotalGrossUBIAmt |
| PY Contributions Grants | $35,373 | PYContributionsGrantsAmt |
| CY Contributions Grants | $109,431 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,076,383 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,765,293 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$132,080 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,925 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$37,386 | PYOtherRevenueAmt |
| CY Other Revenue | $40,756 | CYOtherRevenueAmt |
| PY Total Revenue | $20,942,290 | PYTotalRevenueAmt |
| CY Total Revenue | $21,937,405 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,085,316 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,907,378 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $22,897 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,360,447 | PYOtherExpensesAmt |
| CY Other Expenses | $8,442,700 | CYOtherExpensesAmt |
| PY Total Expenses | $20,445,763 | PYTotalExpensesAmt |
| CY Total Expenses | $21,350,078 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $496,527 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $587,327 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,254,065 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,978,174 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,463,565 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,600,344 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,790,500 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,377,830 | NetAssetsOrFundBalancesEOYAmt |
| Mission | FOUNDED AS A COMMUNITY HOSPITAL, MCKENZIE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT, COMPASSIONATE AND ESSENTIAL HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $21,350,078 | ExpenseAmt |
| Revenue | $21,937,405 | RevenueAmt |
| Desc | Provide inpatient, outpatient and emergency care services Intatient registration = 157 Outpatient registration = 22,744 Emergency room = 6,213 Ambulance runs = 2,309 | Desc |
| Total Program Service Expenses | $21,350,078 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln 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 | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 297 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY RUEDISUELI | PersonNm |
| Phone | 8106486162 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|---|---|
| STEVE BARNETT | |||||||||
| CEOPRESIDENT | 40.00 | Yes (X) | Yes (X) | $200,412 | $0 | $26,585 | |||
| AMY RUEDISUELI | |||||||||
| VP of Finance | 40.00 | Yes (X) | $120,964 | $0 | $7,030 | ||||
| MICHAEL MERKLER | |||||||||
| CHIEF OF STAFF | 40.00 | $253,788 | $0 | $8,540 | Yes (X) | ||||
| JAMES SAMS | |||||||||
| CHIEF OF STAFF | 40.00 | Yes (X) | $206,562 | $0 | $11,500 | ||||
| MATTHEW GORMLEY | |||||||||
| PHYSICIAN | 40.00 | $184,418 | $0 | $28,075 | Yes (X) | ||||
| MARK ENGLISH | |||||||||
| PHYSICIAN | 40.00 | $173,563 | $0 | $28,201 | Yes (X) | ||||
| ALFRED DOMINGO | |||||||||
| PHYSICIAN | $368,690 | $0 | $0 | Yes (X) | |||||
| MICHAEL LEWIS | |||||||||
| NURSE PRACTITIONER | 40.00 | $124,001 | $0 | $4,400 | Yes (X) | ||||
| GINA PATTERSON | |||||||||
| DIRECTOR OF PHARMACY | 32.00 | $121,381 | $34,302 | $24,873 | Yes (X) | 8.000 | |||
| BILLI JO HENNIKA | |||||||||
| VP OF OPERATIONS | 40.00 | Yes (X) | $117,644 | $0 | $24,393 | ||||
| JAY SMITH | |||||||||
| DIAGNOSTIC IMAGING MGR | 40.00 | $115,991 | $0 | $11,401 | Yes (X) | ||||
| CHRISTOPHER CLARK | |||||||||
| CHAIRPERSON | Yes (X) | $0 | $0 | $0 | |||||
| MICHAEL DREYER | |||||||||
| VICE CHAIRPERSON | Yes (X) | $0 | $0 | $0 | |||||
| SUE COOK | |||||||||
| SECRETARYTREASURER | Yes (X) | $0 | $0 | $0 | |||||
| DANIEL BABCOCK | |||||||||
| MARLETTE CEO | Yes (X) | $0 | $0 | $0 | |||||
| GAIL DENTON | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| JUDITH FURGUSON | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| GLEN KAMPMAN | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| LARRY MITCHELL | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| JOAN NAGELKIRK | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| SCOTT ORR | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| LORAINE REISH | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| AL STOUTENBURG | |||||||||
| Director | Yes (X) | $0 | $0 | $0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,987,414 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $34,302 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $174,998 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Michigan Emergency Physici | |||||
| PO BOX 674579 | DETROIT | MI | 482674579 | ER COVERAGE | $1,524,639 |
| EVIDENT | |||||
| PO BOX 850309 | MOBILE | AL | 366850309 | SOFTWARE AND SUPPORT | $206,677 |
| ORTHO-CLINICAL DIAGNOSTICS | |||||
| PO BOX 3655 | CAROL STREAM | IL | 601323655 | LAB SUPPLIES | $188,726 |
| MCKESSON | |||||
| 38220 PLYMOUTH ROAD | LIVONIA | MI | 48150 | PHARMACY DRUG PURCHASES | $319,669 |
| OWENS & MINOR | |||||
| 12199 COLLECTION CENTER DRIVE Ste 1 | CHICAGO | IL | 60693 | SUPPLIES | $259,372 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $109,431 | AllOtherContributionsAmt |
| Total Contributions | $109,431 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| Inpatient Outpatient | $31,539,770 | $31,539,770 |
| Provider Office | $3,835,326 | $3,835,326 |
| RHC Revenue | $1,097,506 | $1,097,506 |
| Contractual Adjust | -$15,451,487 | -$15,451,487 |
| Bad debt Charity | -$808,537 | -$808,537 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,552,715 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,552,715 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,765,293 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,925 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,925 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,339 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,339 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,339 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $32,339 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $71,320 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $62,903 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,417 | TotalRevenueColumnAmt |
| Exclusion | $8,417 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,937,405 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,787,218 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $32,339 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,417 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,287 | TotalAmt |
| Management And General | $397,287 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,299,906 | TotalAmt |
| Program Services | $7,920,998 | ProgramServicesAmt |
| Management And General | $2,366,279 | ManagementAndGeneralAmt |
| Fundraising | $12,629 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,612 | TotalAmt |
| Program Services | $73,462 | ProgramServicesAmt |
| Management And General | $206,150 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,159,263 | TotalAmt |
| Program Services | $190,302 | ProgramServicesAmt |
| Management And General | $968,961 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,310 | TotalAmt |
| Program Services | $533,436 | ProgramServicesAmt |
| Management And General | $236,988 | ManagementAndGeneralAmt |
| Fundraising | $886 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,653 | TotalAmt |
| Management And General | $115,653 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,869 | TotalAmt |
| Management And General | $49,869 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,393,903 | TotalAmt |
| Program Services | $2,953,700 | ProgramServicesAmt |
| Management And General | $440,203 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,499 | TotalAmt |
| Program Services | $25,882 | ProgramServicesAmt |
| Management And General | $59,524 | ManagementAndGeneralAmt |
| Fundraising | $7,093 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,257,860 | TotalAmt |
| Program Services | $1,030,314 | ProgramServicesAmt |
| Management And General | $225,683 | ManagementAndGeneralAmt |
| Fundraising | $1,863 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,526 | TotalAmt |
| Program Services | $36,385 | ProgramServicesAmt |
| Management And General | $268,141 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,523 | TotalAmt |
| Program Services | $325,018 | ProgramServicesAmt |
| Management And General | $7,505 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,430 | TotalAmt |
| Program Services | $100,391 | ProgramServicesAmt |
| Management And General | $23,638 | ManagementAndGeneralAmt |
| Fundraising | $401 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,136 | TotalAmt |
| Program Services | $19,987 | ProgramServicesAmt |
| Management And General | $25,149 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,899 | TotalAmt |
| Program Services | $6,735 | ProgramServicesAmt |
| Management And General | $5,164 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $751,257 | TotalAmt |
| Program Services | $618,850 | ProgramServicesAmt |
| Management And General | $132,407 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,651 | TotalAmt |
| Program Services | $116,130 | ProgramServicesAmt |
| Management And General | $13,521 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Rx | $730,271 | $730,271 | |
| Implant/Blood | $261,054 | $240,433 | $20,621 |
| Tax/Licenses | $272,979 | $272,979 | |
| Food/Laundry | $400,574 | $35,165 | $365,409 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,616 | TotalAmt |
| Program Services | $28,467 | ProgramServicesAmt |
| Management And General | $140,124 | ManagementAndGeneralAmt |
| Fundraising | $25 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,350,078 | TotalAmt |
| Program Services | $15,258,905 | ProgramServicesAmt |
| Management And General | $6,068,276 | ManagementAndGeneralAmt |
| Fundraising | $22,897 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,046 | BOYAmt |
| EOY | $264,346 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,193,100 | BOYAmt |
| EOY | $2,274,949 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,131,057 | BOYAmt |
| EOY | $2,697,098 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $464,564 | BOYAmt |
| EOY | $488,893 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239,478 | BOYAmt |
| EOY | $260,122 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,226,698 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,233,932 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,123,820 | BOYAmt |
| EOY | $3,992,766 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,254,065 | BOYAmt |
| EOY | $9,978,174 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,588,244 | BOYAmt |
| EOY | $1,958,631 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,459,538 | BOYAmt |
| EOY | $1,236,022 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $415,783 | BOYAmt |
| EOY | $405,691 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,463,565 | BOYAmt |
| EOY | $3,600,344 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,716,567 | BOYAmt |
| EOY | $6,303,648 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,933 | BOYAmt |
| EOY | $74,182 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,790,500 | BOYAmt |
| EOY | $6,377,830 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,254,065 | BOYAmt |
| EOY | $9,978,174 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $587,327 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $3 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
| Written Policy Monitoring | false | WrittenPolicyMonitoringInd |
| Section170h Rqr Stsfd | false | Section170hRqrStsfdInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $133,080 | OtherCostOrOtherBasisAmt |
| Book Value | $133,080 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,666,691 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,323,249 | DepreciationAmt |
| Book Value | $2,343,442 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $138,279 | OtherCostOrOtherBasisAmt |
| Depreciation | $127,262 | DepreciationAmt |
| Book Value | $11,017 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,279,314 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,783,421 | DepreciationAmt |
| Book Value | $1,495,893 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,334 | OtherCostOrOtherBasisAmt |
| Book Value | $9,334 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,992,766 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $21,797,632 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $21,797,632 | RevenueSubtotalAmt |
| Other Revenues Not Included | $139,773 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $139,773 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,937,405 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,350,078 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $21,350,078 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $21,350,078 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| P11, Ln 4b | INTEREST INCOME $21,906; CONTRIBUTIONS NET OF |
| P11, Ln 4b | FUNDRAISING $48,647; CONT OF PROP & EQUIP $68,719 |
| P11, Ln 4b | NET ASSETS RELEASED FROM RESTRICT $253; INCREASE IN TEMP |
| P11, Ln 4b | TEMP RESTRICTED ASSETS $248 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HOSP AUXILA | Event1Nm |
| Gross Receipts Event1 | $43,273 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $43,273 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $49,282 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $43,273 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $43,273 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $49,282 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $49,282 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$6,009 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
| Report Publically Available | false | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 13 | PersonsServedCnt |
| Total Community Benefit Expns | $20,019 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,019 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0009 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 4575 | PersonsServedCnt |
| Total Community Benefit Expns | $4,469,721 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,593,731 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,875,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0879 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 4588 | PersonsServedCnt |
| Total Community Benefit Expns | $4,489,740 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,593,731 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,896,009 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0888 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 119 | ActivitiesOrProgramsCnt |
| Persons Served | 5915 | PersonsServedCnt |
| Total Community Benefit Expns | $103,853 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $29,887 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $73,965 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0035 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 37 | PersonsServedCnt |
| Total Community Benefit Expns | $14,902 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,902 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0007 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | -$4,490 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | -$4,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 202 | PersonsServedCnt |
| Total Community Benefit Expns | $5,822 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,896 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,926 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 125 | ActivitiesOrProgramsCnt |
| Persons Served | 6154 | PersonsServedCnt |
| Total Community Benefit Expns | $120,087 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,783 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,303 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0042 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 127 | ActivitiesOrProgramsCnt |
| Persons Served | 10742 | PersonsServedCnt |
| Total Community Benefit Expns | $4,609,827 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,625,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,984,312 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0930 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $473 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $473 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 950 | PersonsServedCnt |
| Total Community Benefit Expns | $2,488 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,488 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 40 | PersonsServedCnt |
| Total Community Benefit Expns | $187 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $187 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 700 | PersonsServedCnt |
| Total Community Benefit Expns | $2,088 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,088 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 1690 | PersonsServedCnt |
| Total Community Benefit Expns | $5,236 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,236 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $783,526 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $32,302 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,128,250 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,229,273 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$101,023 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE HEALTH SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1Txt |
| City | SANDUSKY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.mckenziehealth.org | WebsiteAddressTxt |
| State License | 760030 | StateLicenseNum |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.mckenziehealth.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.mckenziehealth.org/wp-content/uploads/2016/12/2 | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Form4720 Filed | false | Form4720FiledInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.mckenziehealth.org/patien | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.mckenziehealth.o | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.mckenzieh | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 3J | Describes prioritized ID needs. CHNA implements ID plan & strategy |
| 5 | Hospital focus groups include reps from Sandusky City Council, Thumb Elite |
| 5 | athletics, Sandusky Arts Council, City Police Dept., parents, educational |
| 5 | Professionals & Churches. Key stakeholders interviewed with a rep from MI |
| 5 | Dept of health & human services, Sanilac County Mental Health & Sanilac Int |
| 5 | School District. |
| 6a | Marlette Regional Hospital, Scheurer Hospital, Deckerville Hospital, Caro |
| 6a | Community Hospital, Huron Medical Center & Hills & Dales Hospital. |
| 6b | Sanilac County HD, Tuscola County HD, Huron County HD |
| 7d | CHNA was distributed to Lions club, MHS BOD, Sanilac County Mental Health, |
| 7d | Sanilac County transportation, Sanilac County Dept of Health & Human Serv. |
| 7d | Great Start collaborative, Blue Water Center for Rural Living, Sanilac Lit. |
| 7d | Sanilac probabtion & Sanilac County Sherif's Dept. |
| 11 | Committees address significant needs identified by the CHNA, Including; |
| 11 | more evening & weekend provider hours, more specialists, lack of health ins |
| 11 | awareness of health resources and services, jobs with liveable wages, avail |
| 11 | of mental health services, crime & safety, cost of ins. youth/adult obesity |
| 11 | Committees work with local organizations, such as; law enforcement, mental |
| 11 | health, schools, Sanilac transportation, specialty practices in surrounding |
| 11 | areas, telehealth options, nurse hotlines and local media to advertise serv |
| 11 | and programs. |
| 11 | SEE ATTACHED FOR ADDITIONAL INFORMATION. |
| 38-1738615 | 3J |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| McKenzie Health & Wellness | ||||
| 170 W ARGYLE ST | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| MCKENZIE RURAL HEALTH CLIN | ||||
| 75 DAWSON ST | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| MCKENZIE FAMILY HEALTHCARE | ||||
| 109 N DELAWARE ST | SANDUSKY | MI | 48471 | PROVIDER OFFICE |
| LAKESHORE INTERNAL MEDICIN | ||||
| 7307 CHERRY ST | PORT SANILAC | MI | 48469 | PROVIDER OFFICE |
| CROSWELL CLINIC | ||||
| 8 N HOWARD ST | CROSWELL | MI | 48422 | PROVIDER OFFICE |
| PECK MEDICAL CLINIC | ||||
| 251 E PECK RD | PECK | MI | 48466 | PROVIDER OFFICE |
| SANILAC MEDICAL PLAZA | ||||
| 100 W ARGYLE ST | SANDUSKY | MI | 48471 | PROVIDER OFFICE/RENTAL |
Supplemental Information Detail SupplementalInformationDetail (28 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I line 6a | A community benefit report was prepared during the 2015 tax year. |
| Part I line 7 | Schedule H worksheets were used to prepare the cost to charge ratio. |
| Part II | McKenzie promoted Community health through various activities, such as; |
| Part II | Senior fair, school tours, County 4-H fair, & various showcases. |
| Part III line 2 | Bad debts are est by the allowance method & indp. audited annually, listed |
| Part III line 2 | net of discounts and payments rec'd on account post bad debt determination. |
| Part III line 3 | Cost to charge ratio was used for denied FAP applications. |
| Part III line 4 | See attached audited Financial Statements, page 13 & 14 note 1 |
| Part III line 8 | McKenzie is a critical access hospital under medicare reg., reimbursed |
| Part III line 8 | based on costs. Some necessary serv are not reimburable costs. |
| Part III line 8 | The shortfall of $101,023 consists of these services plus 2% sequestration. |
| Part III line 8 | Medicare cost report data was used to calculate these figures. |
| Part III line 9b | Collection policy references the FAP for those patients that are eligable |
| Part III line 9b | are eligable for assistence as a method of payment for Hospital accounts. |
| Part VI -2 | In addition to items in SCH H part V sec B, CNHA describes how identified |
| Part VI -2 | needs were prioritized & strategy was implemented. MHS also continuously |
| Part VI -2 | monitors quality scores and patient satisfaction surveys. MHS leadership |
| Part VI -2 | is in constant contact with other healthcare agencies in the community and |
| Part VI -2 | accesses any findings identified through collaboration. |
| Part VI -3 | Uninsured patients receive a Financial policy brochure from staff. Dir. of |
| Part VI -3 | Human Services then follows up with the patient to help apply for medicare/ |
| Part VI -3 | medicaid and apply of FAP program. This info is also available in brochure |
| Part VI -3 | website, patient statement, hospital lobby, ER & patient fin. services. |
| Part VI -4 | MHS is a critical access hosp. located in Sanilac County; population 41,587 |
| Part VI -4 | 1600 sq miles and 90% rural. 52% of population has some college, median |
| Part VI -4 | income is $42,100. 15% of population in uninsured. unemployment rate is |
| Part VI -4 | 8.4% and 23% of children live in poverty. |
| Part VI -5 | Gov. by Board of Directors, Serv.; Geriatrics, immunization, physicals, etc |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|
| STEVE BARNETT | |||||||
| CEOPRESIDENT | $200,412 | $7,594 | $18,991 | $226,997 | |||
| AMY RUEDISUELI | |||||||
| VP of Finance | $120,964 | $120,964 | |||||
| MICHAEL MERKLER | |||||||
| CHIEF OF STAFF | $253,788 | $8,540 | $262,328 | ||||
| JAMES SAMS | |||||||
| CHIEF OF STAFF | $206,562 | $7,245 | $4,255 | $218,062 | |||
| MATTHEW GORMLEY | |||||||
| PHYSICIAN | $184,418 | $7,219 | $20,856 | $212,493 | |||
| MARK ENGLISH | |||||||
| PHYSICIAN | $173,563 | $6,556 | $21,645 | $201,764 | |||
| ALFRED DOMINGO | |||||||
| PHYSICIAN | $368,690 | $368,690 | |||||
| MICHAEL LEWIS | |||||||
| NURSE PRACTITIONER | $124,001 | $124,001 | |||||
| GINA PATTERSON | |||||||
| DIRECTOR OF PHARMACY | $121,381 | $5,430 | $19,443 | $146,254 | $34,302 | $34,302 | |
| BILLI JO HENNIKA | |||||||
| VP OF OPERATIONS | $117,644 | $4,514 | $19,879 | $142,037 | |||
| JAY SMITH | |||||||
| DIAGNOSTIC IMAGING MGR | $115,991 | $115,991 | |||||
| CHRISTOPHER CLARK | |||||||
| CHAIRPERSON | |||||||
| MICHAEL DREYER | |||||||
| VICE CHAIRPERSON | |||||||
| SUE COOK | |||||||
| SECRETARYTREASURER | |||||||
| DANIEL BABCOCK | |||||||
| MARLETTE CEO | |||||||
| GAIL DENTON | |||||||
| Director | |||||||
| JUDITH FURGUSON | |||||||
| Director | |||||||
| GLEN KAMPMAN | |||||||
| Director | |||||||
| LARRY MITCHELL | |||||||
| Director | |||||||
| JOAN NAGELKIRK | |||||||
| Director | |||||||
| SCOTT ORR | |||||||
| Director | |||||||
| LORAINE REISH | |||||||
| Director | |||||||
| AL STOUTENBURG | |||||||
| Director | |||||||
Schedule L IRS990ScheduleL
Disqualified Person Ex Bnft Tr DisqualifiedPersonExBnftTrGrp (6 entries)
| Transaction CorrectedTransactionCorrectedInd |
|---|
| false |
| false |
| false |
| false |
| false |
| false |
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (10 entries)
| DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
| false | false | false |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (10 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| BARNETT ANESTHESIA | |||
| CEO's Spouse | $102,175 | CRNA Services | false |
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
| (no name) | |||
| false | |||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (19 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 6 | CLASSES OF MEMBERS MAKE UP THE BOARD OF DIRECTORS |
| Part VI Line 7a | BOARD MEMBERS MUST BE APPROVED BY THE BOARD OF UNITED HEALTHCARE |
| Part VI Line 7a | PARTNERS TO BECOME BOARD MEMBERS. |
| Part VI Line 11b | FINANCE COMMITTEE FIRST REVIEWS THE 990 WITH ALL SCHEDULES AND THE 990-T |
| Part VI Line 11b | REPORT IS THEN REVIEWED BY THE FULL BOARD. |
| Part VI Line 12c | BOARD AND COMMITTEE MEMBERS ARE REQUIRED TO ANNUALLY FILL OUT THE |
| Part VI Line 12c | CONFLICT OF INTEREST POLICY AND ABSTAIN FROM ANY CONFLICTING VOTE. |
| Part VI Line 15a or b | COMPENSATION IS APPROVED BY THE FULL BOARD, BASED ON RECOMMENDATIONS |
| Part VI Line 15a or b | FROM COMPENSATION SURVEYS. |
| Part VI Line 19 | ALL DOCUMENTS ARE AVAILABLE FOR INSPECTION AT REQUEST AT THE CEO/PRESIDENT |
| Part VI Line 19 | OFFICE. |
| Part VII | Compensation is provided for the 2016 tax (calendar) year |
| Part IX Line 11g | Other professional fees Total expenses - $3393903.00 Program service expenses - $2953700.00 Mgmt and general expenses - $440203.00 Fundraising expenses - $0.00 |
| Part IX Line 24e | Misc. Total expenses - $168616.00 Program service expenses - $28467.00 Mgmt and general expenses - $140124.00 Fundraising expenses - $25.00 |
| Part XI Line 9 | CORRECTION FOR ROUNDING TO WHOLE NUMBERS |
| Part VI Line 7b | United Healthcare Partners must approve any Financial Transactions above |
| Part VI Line 7b | one million dollars prior to being taken to to the BOD at McKenzie. |
| Part IX Line 11g | Total Other Professional Fees of $3,393,903 include: Prof. services medical |
| Part IX Line 11g | $2,685,451, Prof Service Non-medical $513,981, & Service contracts $194,471 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sanilac Services Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 78 ELK Street | AddressLine1Txt |
| City | Sandusky | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48471 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382774983 | EIN |
| Primary Activities | Retail pharmacy | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Total Income | -$29,458 | TotalIncomeAmt |
| End Of Year Assets | $960,077 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McKenzie Memorial Hospita | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Marlette Regional Hospital | ||||||||||
| 2770 Main Street PO Box 307 | Marlette | MI | 48453 | 381507302 | Healthcare | MI | 501 C | 3 | United Healthcare Partner | false |
| United Healthcare Partners | ||||||||||
| 120 Delaware St | Sandusky | MI | 48471 | 465444203 | Healthcare | MI | 501 C | 3 | ITSELF | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | 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 (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Sanilac Services Inc | ||
| H | $9,160 | Cost basis |
| (no name) | ||
| K | $11,250 | FMV |
| Sandusky | ||
| L | $90,000 | Cost basis |
| (no name) | ||
| Q | $62,441 | Cost basis |
| (no name) | ||
| S | $250,903 | Cost basis |
| Marlette Regional Hospital | ||
| O | $224,563 | Cost basis |
| (no name) | ||
| P | $50,165 | Cost basis |
| Marlette | ||
| Q | $28,619 | Cost basis |
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