THREE RIVERS HEALTH SYSTEM INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- THREE RIVERS HEALTH SYSTEM INC (EIN 45-1257972)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201713199349315136
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T16:21:25-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 | 750 Trade Centre Way Ste 300 | AddressLine1Txt |
| City | Portage | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49002 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 451257972 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | THRE | BusinessNameControlTxt |
| Phone | 2692781145 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1Txt |
| City | THREE RIVERS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49093 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | steve andrews | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2692781145 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Carol LaLonde CPA | PreparerPersonNm |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | PhoneNum |
| Preparation | 2017-11-15 | 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 | 2017-11-15 | IPDt |
| IP Tm | 15:25:08 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 737BA0023E8B7B7720E7709DD3402E7D4390A0C6 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE ANDREWS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1Txt |
| City | THREE RIVERS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49093 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $61,559,373 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.THREERIVERSHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 587 | TotalEmployeeCnt |
| Total Volunteers | 101 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $326,461 | PYContributionsGrantsAmt |
| CY Contributions Grants | $295,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $56,016,354 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $61,013,031 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,585 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,024 | CYInvestmentIncomeAmt |
| PY Other Revenue | $196,613 | PYOtherRevenueAmt |
| CY Other Revenue | $206,807 | CYOtherRevenueAmt |
| PY Total Revenue | $56,542,013 | PYTotalRevenueAmt |
| CY Total Revenue | $61,529,862 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $25,761,744 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,472,234 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $30,432,014 | PYOtherExpensesAmt |
| CY Other Expenses | $33,531,306 | CYOtherExpensesAmt |
| PY Total Expenses | $56,193,758 | PYTotalExpensesAmt |
| CY Total Expenses | $62,003,540 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $348,255 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$473,678 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,925,787 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,972,640 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,128,495 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,649,026 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,797,292 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,323,614 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THREE RIVERS HEALTH IS COMMITTED TO THE SUSTAINED WELL BEING OF OUR PATIENTS, FAMILIES, AND COMMUNITIES THROUGH HIGH QUALITY, LOW COST, DYNAMIC HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $51,012,529 | ExpenseAmt |
| Revenue | $61,013,031 | RevenueAmt |
| Desc | GENERAL ACUTE SERVICES FOR COMMUNITY INPATIENT AND OUTPATIENT SERVICES. | Desc |
| Total Program Service Expenses | $51,012,529 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| 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 | 0 | 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 | 0 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 587 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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 |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVEN T ANDREWS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2692739604 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1Txt |
| City | THREE RIVERS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49093 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| LARRY CLARK | ||||||||
| BOARD CHAIR | 5.00 | 1.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LAURIE HINES | ||||||||
| VICE CHAIR | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DIANA DEGRAAF | ||||||||
| SECRETARY | 3.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RAY BENDURE | ||||||||
| TREASURER | 5.00 | 1.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARY BETH FLEURY | ||||||||
| BOARD MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JANELL HART | ||||||||
| BOARD MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN TOUSE | ||||||||
| BOARD MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES MACDONALD DO | ||||||||
| BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $0 | $328,495 | $51,157 | ||
| RICK CORDES | ||||||||
| BOARD MEMBER | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JESSICA PUCKETT DO | ||||||||
| CHIEF OF STAFF | 40.00 | 0.00 | Yes (X) | $0 | $362,502 | $36,722 | ||
| ANDY GOLDBERGER | ||||||||
| BOARD MEMBER - PART YEAR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUG MITCHELL | ||||||||
| BOARD MEMBER - PART YEAR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER GRABER | ||||||||
| BOARD MEMBER - PART YEAR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GLENDORA GREENE MD | ||||||||
| BOARD MEMBER - PART YEAR | 40.00 | 0.00 | Yes (X) | $0 | $53,075 | $5,465 | ||
| WILLIAM RUSSELL | ||||||||
| PRESIDENT/CEO | 40.00 | 4.00 | Yes (X) | $275,241 | $0 | $77,213 | ||
| STEVE ANDREWS | ||||||||
| CFO | 40.00 | 4.00 | Yes (X) | $183,206 | $0 | $62,950 | ||
| HOPE BAILEY | ||||||||
| VICE PRESIDENT | 40.00 | 3.00 | Yes (X) | $152,544 | $0 | $31,910 | ||
| BRIAN CLARK | ||||||||
| CRNA | 40.00 | 0.00 | $257,506 | $0 | $46,882 | Yes (X) | ||
| CHAD BUSH | ||||||||
| CRNA | 40.00 | 0.00 | $256,719 | $0 | $45,773 | Yes (X) | ||
| RANDALL SMITH | ||||||||
| CRNA | 40.00 | 0.00 | $252,402 | $0 | $25,232 | Yes (X) | ||
| LEONARD DARLING | ||||||||
| PHARMACY MANAGER | 40.00 | 0.00 | $140,126 | $0 | $27,950 | Yes (X) | ||
| LYNETTE BURKETT | ||||||||
| AUDIOLOGIST | 40.00 | 0.00 | $132,832 | $0 | $25,369 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,650,576 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $744,072 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $436,623 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QHR | |||||
| 1573 MALLORY LANE | BRENTWOOD | TN | 37027 | HOSPITAL MANAGEMENT | $993,702 |
| BORGESS MEDICAL CENTER | |||||
| 1521 GULL ROAD | KALAMAZOO | MI | 49048 | PHYSICIAN, IT SERVICES, LAUNDRY | $964,644 |
| WEST MICHIGAN ENT | |||||
| 3850 GLENKERRY COURT | PORTAGE | MI | 49024 | PHYSICIAN SERVICES | $948,356 |
| KALAMAZOO FOOT & ANKLE | |||||
| 12057 WEST INDIAN LAKE DR | VICKSBURG | MI | 49097 | PHYSICIAN SERVICES | $945,094 |
| ATHENA HEALTH | |||||
| 311 ARSENAL ST | WATERTOWN | MA | 02472 | REVENUE CYCLE SERVICES | $634,774 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $295,000 | AllOtherContributionsAmt |
| Total Contributions | $295,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $61,013,031 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,013,031 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $61,013,031 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,374 | TotalRevenueColumnAmt |
| Exclusion | $5,374 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $111,088 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,511 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $81,577 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $81,577 | TotalRevenueColumnAmt |
| Exclusion | $81,577 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $9,650 | 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 | $9,650 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,650 | TotalRevenueColumnAmt |
| Exclusion | $9,650 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/VENDING | 900099 | $98,131 | $98,131 |
| MISCELLANEOUS | 900099 | $27,099 | $27,099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $125,230 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,529,862 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,013,031 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $221,831 | 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 | $783,064 | TotalAmt |
| Program Services | $313,226 | ProgramServicesAmt |
| Management And General | $469,838 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,771,091 | TotalAmt |
| Program Services | $18,811,190 | ProgramServicesAmt |
| Management And General | $2,959,901 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,613 | TotalAmt |
| Program Services | $206,652 | ProgramServicesAmt |
| Management And General | $22,961 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,264,374 | TotalAmt |
| Program Services | $3,837,937 | ProgramServicesAmt |
| Management And General | $426,437 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,424,092 | TotalAmt |
| Program Services | $1,281,683 | ProgramServicesAmt |
| Management And General | $142,409 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $782,677 | TotalAmt |
| Program Services | $234,803 | ProgramServicesAmt |
| Management And General | $547,874 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,777 | TotalAmt |
| Management And General | $396,777 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,937 | TotalAmt |
| Program Services | $19,787 | ProgramServicesAmt |
| Management And General | $79,150 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,088 | TotalAmt |
| Management And General | $9,088 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,437 | TotalAmt |
| Program Services | $21,437 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,511,198 | TotalAmt |
| Program Services | $4,687,889 | ProgramServicesAmt |
| Management And General | $4,823,309 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,738 | TotalAmt |
| Program Services | $610 | ProgramServicesAmt |
| Management And General | $2,128 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,858 | TotalAmt |
| Management And General | $119,858 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $871,838 | TotalAmt |
| Program Services | $871,838 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,677 | TotalAmt |
| Program Services | $158,677 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,191 | TotalAmt |
| Program Services | $244,191 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,127,744 | TotalAmt |
| Program Services | $2,127,744 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,496 | TotalAmt |
| Program Services | $65,540 | ProgramServicesAmt |
| Management And General | $362,956 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $7,552,725 | $7,396,727 | $155,998 |
| PHYSICIAN FEES | $4,465,472 | $4,465,472 | |
| BAD DEBT EXPENSE | $4,267,550 | $4,267,550 | |
| EQUIP RENTAL AND MAINTE | $1,988,195 | $1,515,868 | $472,327 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,708 | TotalAmt |
| Program Services | $483,708 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,003,540 | TotalAmt |
| Program Services | $51,012,529 | ProgramServicesAmt |
| Management And General | $10,991,011 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,433,608 | BOYAmt |
| EOY | $3,387,989 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,545,816 | BOYAmt |
| EOY | $3,091,440 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,933 | BOYAmt |
| EOY | $921,282 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $869,941 | BOYAmt |
| EOY | $779,997 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $51,747,599 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $43,127,371 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,603,290 | BOYAmt |
| EOY | $8,620,228 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $414,698 | BOYAmt |
| EOY | $119,151 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,501 | BOYAmt |
| EOY | $52,553 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,925,787 | BOYAmt |
| EOY | $16,972,640 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,879,562 | BOYAmt |
| EOY | $5,769,858 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,773,971 | BOYAmt |
| EOY | $4,931,922 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $474,962 | BOYAmt |
| EOY | $947,246 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,128,495 | BOYAmt |
| EOY | $11,649,026 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,797,292 | BOYAmt |
| EOY | $5,323,614 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,797,292 | BOYAmt |
| EOY | $5,323,614 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,925,787 | BOYAmt |
| EOY | $16,972,640 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$473,678 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $9,088 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,088 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF MHA DUES IS ALLOCATED TO LOBBYING EXPENSE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $219,500 | OtherCostOrOtherBasisAmt |
| Book Value | $219,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,192,504 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,774,713 | DepreciationAmt |
| Book Value | $5,417,791 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,485,997 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,419,178 | DepreciationAmt |
| Book Value | $66,819 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,849,598 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,933,480 | DepreciationAmt |
| Book Value | $2,916,118 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,620,228 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COST REPORT SETTLEMENTS PAYABLE | Desc |
| Amt | $947,246 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $947,246 | 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 |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | $70,260 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $70,260 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,251,208 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,106,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,144,694 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07180 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,321,468 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,106,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,214,954 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07300 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $116,396 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $116,396 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $264,637 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $264,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,688,670 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,143,929 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,544,741 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09600 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,069,703 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,143,929 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,925,774 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10260 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,391,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,250,443 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,140,728 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17560 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,267,550 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $685,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,579,162 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,334,176 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$755,014 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1Txt |
| City | Three Rivers | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49093 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 1060000006 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH | 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 |
| Other | Yes (X) | OtherInd |
| 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 | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.threerivershealth.org/ | 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 | http://www.threerivershealth.org/ | 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 | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 | http://www.threerivershealth.org/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.threerivershealth.org/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.threerivershealth.org/financial-assistance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| THREE RIVERS HEALTH | Part V, Section B, Line 3j: THE CHNA CONTENT INCLUDED THE PROJECT OBJECTIVES, AN OVERVIEW OF THE ASSESSMENT, AS WELL AS THE FINANCIAL OPPORTUNITY SUMMARY. THE REPORT SUMMARIZED THE APPROACH AND ITS FINDINGS. IT ALSO COMPARED HOW THE COMMUNITY COMPARED TO ITS PEERS AND SUMMARIZED KEY CONCLUSIONS AND OBSERVATIONS. FINALLY, IT RANKED THE NEEDS OF THE COMMUNITY, AND IDENTIFIED AN ACTION PLAN TO HELP IMPLEMENT THE IMPROVEMENT IN COMMUNITY HEALTH OVERALL. |
| THREE RIVERS HEALTH | Part V, Section B, Line 5: INITIALLY, WE DEPLOYED A NEEDS ASSESSMENT SURVEY WITHIN THE LOCAL POPULATION FOR ANY RESIDENT TO COMPLETE. WE RECEIVED INPUT FROM 620 AREA RESIDENTS. IT WAS AN INTERNET BASED SURVEY THAT WAS PROMOTED VIA ADVERTISING AND THROUGH LOCAL CIVIC AND HEALTH ORGANIZATIONS. PRELIMINARY CONCLUSIONS WERE THEN PRESENTED TO A LOCAL GROUP OF EXPERTS WHO WERE ASKED TO VALIDATE PRIOR ASSESSMENTS AND TO ESTABLISH PRIORITY AMONG VARIOUS IDENTIFIED HEALTH AND MEDICAL ISSUES. WHEN THE FINAL ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL GROUP OF EXPERTS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. SOME OF THE OTHER LOCAL ORGANIZATIONS THAT HELPED WITH THIS PROCESS WERE STURGIS HOSPITAL, COMMUNITY MENTAL HEALTH DEPARTMENT, BRANCH HILLSDALE- ST. JOSEPH COMMUNITY HEALTH AGENCY, AND ST. JOSEPH COUNTY COMMISSION ON AGING. |
| THREE RIVERS HEALTH | Part V, Section B, Line 6a: STURGIS HOSPITAL |
| THREE RIVERS HEALTH | Part V, Section B, Line 6b: COMMUNITY MENTAL HEALTH |
| THREE RIVERS HEALTH | Part V, Section B, Line 11: The Hospital and its Board chose five areas to focus on: Diabetes, education and prevention, physician services, Mental Health and Suicide, Obesity and physical inactivity. Dieticians at Three Rivers Health laid the foundation for the Pre-Diabetes Program titled, "Mindset 365" for employees and the community. Education and Prevention is addressed through skin and prostate cancer screening to community members. Physician Services; Primary Care, Orthopedics, and Specialist recruitment efforts were made. Mental Health and Suicide; worked through CON for services but Three Rivers Health did not proceed due to financial constraints and the inability to recruit a Psychiatrist. Obesity and Physical Inactivity is addressed through a School Based Clinic that is an outreach to children with these issues. The hospital Health facility is open to the community and passes are donated to children with these specific issues. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 13 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - THREE RIVERS HEALTH INTERNAL MEDICINE | ||||
| 711 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | RURAL HEALTH CLINIC - INTERNAL MEDICINE, FAMILY CARE & WOMEN'S SERV |
| 2 - Three Rivers Health Orthopedics | ||||
| 1021 HILL STREET | THREE RIVERS | MI | 49093 | ORTHOPEDICS |
| 3 - Three Rivers Health Family Care | ||||
| 721 6TH AVENUE STE B | THREE RIVERS | MI | 49093 | RURAL HEALTH CLINIC - THREE RIVERS |
| 4 - Center for Wound Healing | ||||
| 721 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | WOUND CARE |
| 5 - Three Rivers Bone and Joint | ||||
| 1021 HILL STREET | THREE RIVERS | MI | 49093 | BONE AND JOINT FACILITY |
| 6 - Three Rivers Health Family Care | ||||
| 601 E CHICAGO RD | WHITE PIGEON | MI | 49099 | RURAL HEALTH CLINIC - WHITE PIGEON |
| 7 - Three Rivers Health Surgical Services | ||||
| 715 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | SURGICAL SERVICES |
| 8 - Homecare and Hospice | ||||
| 633 S ERIE STREET | THREE RIVERS | MI | 49093 | HOSPICE CARE |
| 9 - Health Trac - Wellness Pavillion | ||||
| 501 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | WELLNESS CENTER |
| 10 - Three Rivers Center for Family Medicine | ||||
| 850 S Health Parkway | THREE RIVERS | MI | 49093 | PRIMARY CARE |
| 11 - Veera Patel MD - Internal Medicine | ||||
| 1021 HILL ST SUITE 300 | THREE RIVERS | MI | 49093 | INTERNAL MEDICINE |
| 12 - Three Rivers Health Family Care | ||||
| 110 EAST MAIN | MARCELLUS | MI | 49067 | HEALTH CLINIC - MARCELLUS |
| 13 - Three Rivers Health Endocrinology | ||||
| 715 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | ENDOCRINOLOGY |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | LINES 7 A THROUGH 7C ARE REPORTED USING THE COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2. LINES 7E THROUGH 7G ARE REPORTED USING DIRECT COSTS FOR CLINIC OPERATIONS. A COST ACCOUNTING SYSTEM WAS USED FOR HOSPITAL OPERATIONS. |
| Part I, Line 7g: | OTHER SUBSIDIZED HEALTH SERVICES INCLUDES GROSS CLINIC COSTS OF $11,694,006. |
| Part I, Line 7, Column (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 $ 4,267,550. |
| Part III, Line 2: | BAD DEBT EXPENSE ARE DOLLARS THAT ARE WRITTEN OFF OR RESERVED FOR PATIENTS THAT HAVE AVAILABLE RESOURCES, BUT WOULD NOT PAY FOR SERVICES. THE EXCEPTION TO THIS RULE WOULD BE CHARITY CARE ACCOUNTS THAT ARE INCLUDED IN BAD DEBT BECAUSE OF A LACK OF INFORMATION PROVIDED. PAYMENTS ON ACCOUNTS THAT HAVE BEEN WRITTEN OFF WOULD REDUCE THE OVERALL BAD DEBT EXPENSE. DISCOUNTS ON CHARGES ARE NOT INCLUDED IN BAD DEBT EXPENSE. |
| Part III, Line 3: | SEE ABOVE FOR METHODOLOGY. WITH REGARDS TO CHARITY CARE, THE HOSPITAL ESTIMATES THAT APPROXIMATELY $685,000 OF CHARITY CARE IS INCLUDED IN BAD DEBT EXPENSE DUE TO NOT RECEIVING INFORMATION FROM PATIENTS TO HELP DETERMINE ELIGIBILITY, THUS WE BELIEVE THE $685,000 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. |
| Part III, Line 4: | Accounts receivable for patients, insurance companies, and governmental agencies are based on gross charges. An allowance for contractual adjustments and interim payment advances is based on expected payment rates from payors based on current reimbursement methodologies. This amount also includes amounts received as interim payments against unpaid claims by certain payors. An allowance for uncollectible accounts is established on an aggregate basis by using historical write-off factors applied to unpaid accounts based on aging. Loss rate factors are based on historical loss experience and adjusted for economic conditions and other trends affecting the Organization's ability to collect outstanding amounts. Uncollectible amounts are written off against the allowance for doubtful accounts in the period they are determined to be uncollectible. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Organization 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. |
| Part III, Line 8: | MEDICARE IS OUR LARGEST PAYOR, THUS PAYMENTS FOR THIS POPULATION CREATE A FINANCIAL BURDEN ON THE HOSPITAL AS PAYMENTS DO NOT COVER COSTS. MOST OF THE MEDICARE PATIENTS LIVE ON FIXED INCOMES. WE USED THE COST TO CHARGE RATIO TO DETERMINE COSTS. AS MEDICARE IS OUR LARGEST PAYOR, THE SHORTFALL IN COVERING COSTS IS EXTREME, THUS THIS WOULD SEEM TO QUALIFY AS A BENEFIT TO OUR COMMUNITY. |
| Part III, Line 9b: | THE HOSPITAL'S CURRENT COLLECTION PROCESS APPLIES TO ALL PATIENTS. IF NO INSURANCE IS AVAILABLE FOR SERVICES, AND THEY DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL MAKE THEM AWARE OF THEIR OPTIONS. DISCOUNTS ARE OFFERED WHICH ARE TIED TO COMMERICAL MANAGED CARE CONTRACTS. PAYMENT ARRANGEMENTS CAN BE MADE FOR A SPECIFIC PERIOD OF TIME, WITH NO INTEREST CHARGED. ONCE ARRANGEMENTS ARE MADE, THE ACCOUNT FOLLOWS THE STANDARD COLLECTION PROCESS OF LETTERS AND PHONE CALLS. AFTER 120 DAYS, IF NO PAYMENT HAS BEEN MADE OR IF PAYMENT ARRANGEMENTS ARE NOT KEPT, THE ACCOUNT WILL BE REFERRED TO A COLLECTION AGENCY. |
| Part VI, Line 2: | THE HOSPITAL CURRENTLY REVIEWS THE HEALTH INDICATORS OF THE COUNTY, AND WILL FROM TIME TO TIME COMPLETE COMMUNITY SURVEYS. WE ASSESS WHETHER WE HAVE A SHORTAGE OF PHYSICIANS IN THE AREA ANNUALLY AS WELL. WE REVIEW TRENDS OF OUR PATIENT ACTIVITY BY SERVICE AND TYPE OF PATIENT TO SEE IF ADJUSTMENTS IN SERVICE OR RESOURCE ALLOCATION NEED TO BE MADE. WE REVIEW OUR PATIENT SATISFACTION SURVEYS PERIODICALLY TO IDENTIFY ANY POTENTIAL GAPS IN SERVICES. WE PARTNER WITH THE LOCAL SCHOOLS AND COMMUNITY MENTAL HEALTH ON SPECIFIC HEALTH INITIATIVE THROUGHOUT THE YEAR. OUR MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN 2016. WE ALSO PARTNER WITH THE OTHER HOSPITAL IN THE COUNTY - STURGIS HOSPITAL. |
| Part VI, Line 3: | UPON IDENTIFYING PATIENTS WHO HAVE NO COVERAGE, WE WILL SEND THEM TO OUR PATIENT ASSISTANCE REPRESENTATIVE. THIS PERSON WILL THEN REVIEW THE OPTIONS THAT ARE AVAILABLE FOR THIS INDIVIDUAL. IF MEDICAID IS A POSSIBILITY, WE THEN SEND THIS PERSON TO OUR MEDICAID SPECIALIST, WHO WILL HELP THEM WITH THE PROCESS, AS WELL AS ANY FORMS. WE HAVE A FORMAL FINANCIAL ASSISTANCE PROGRAM THAT IS ADVERTISED HOSPITAL WIDE AND ON OUR WEBSITE. IF THEY QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL EDUCATE THEM AND ASSIST THEM WITH THE PROCESS. |
| Part VI, Line 4: | THE HOSPITAL PRESENTLY SERVES ST. JOSEPH COUNTY, ALONG WITH OTHER PROVIDERS AS WELL. THE ESTIMATED POPULATION OF THE TOTAL MARKET IS AROUND 62,000. THE COMMUNITY WAS HEAVILY DEPENDENT ON THE AUTO INDUSTRY AND THUS THE ECONOMY HAS STRUGGLED IN RECENT YEARS. WHILE THE OVERALL ECONOMY IN THE STATE HAS REBOUNDED SOMEWHAT, THE LOCAL COUNTY HAS LAGGED IN THE RECOVERY. THE UNEMPLOYMENT RATE CONTINUES TO BE HIGH, AND THE MEDICAID POPULATION IN THE COMMUNITY IS EXTREMELY HIGH. ADDITIONALLY, PEOPLE WITH COVERAGE HAS ALSO INCREASED. BECAUSE OF THIS, MANY PEOPLE USE THE ER AS THEIR PRIMARY CARE PROVIDER. WHILE THE COMMUNITY IS RURAL, IT IS CLOSE TO URBAN AREAS. MANY PEOPLE IN THE COMMUNITY DO NOT HAVE ADEQUATE TRAVEL ARRANGEMENTS, AS CAN BE EVIDENCED BY HIGH NO SHOW RATES FOR PRIMARY CARE APPOINTMENTS DUE TO TRAVEL ISSUES. |
| Part VI, Line 5: | THE HOSPITAL HAS A BOARD THAT RESIDES ENTIRELY IN THE COMMUNITY IT SERVES. THE HOSPITAL HAS EXTENDED PRIVILEGES TO ALL QUALIFIED STAFF IN THE COMMUNITY, AND AS MENTIONED ABOVE, HAS SET UP ARRANGEMENTS WITH TERTIARY HOSPITALS TO ARRANGE FOR SPECIALIST TO PROVIDE CARE IN THE COMMUNITY ON AN AS NEEDED BASIS. THIS IS CRITICAL, AS THIS MEANS THE LOCAL POPULATION DOES NOT HAVE TO TRAVEL EXTENSIVELY FOR THIS SPECIALTY CARE. IF SURPLUS FUNDS ARE AVAILABLE, THESE FUNDS ARE INVESTED BACK INTO THE COMMUNITY, BY ALLOCATING DOLLARS FOR MEDICAL EQUIPMENT REPLACEMENT, PHYSICIAN RECRUITING, AND OTHER COMMUNITY INITIATIVES. THE HOSPITAL ALSO CONTINUES TO ESTABLISH RURAL HEALTH CLINICS IN COMMUNITIES SURROUNDING ITS SERVICE AREA. THE HOSPITAL IS ALSO A MEMBER OF AN ACO, AND THE HOSPITAL HAS HIRED A CARE COORDINATOR TO HELP WITH CHRONIC CARE PATIENTS AND TO HELP PROMOTE ANNUAL WELLNESS VISTS AS WELL. |
| Part VI, Line 7, Reports Filed With States | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES MACDONALD DO | ||||||||||||||
| BOARD MEMBER | $0 | $314,995 | $0 | $0 | $0 | $13,500 | $0 | $18,000 | $0 | $33,157 | $0 | $379,652 | $0 | $0 |
| JESSICA PUCKETT DO | ||||||||||||||
| CHIEF OF STAFF | $0 | $332,502 | $0 | $0 | $0 | $30,000 | $0 | $17,500 | $0 | $19,222 | $0 | $399,224 | $0 | $0 |
| WILLIAM RUSSELL | ||||||||||||||
| PRESIDENT/CEO | $244,201 | $0 | $23,000 | $0 | $8,040 | $0 | $0 | $0 | $77,213 | $0 | $352,454 | $0 | $0 | $0 |
| STEVE ANDREWS | ||||||||||||||
| CFO | $180,275 | $0 | $0 | $0 | $2,931 | $0 | $3,800 | $0 | $59,150 | $0 | $246,156 | $0 | $0 | $0 |
| HOPE BAILEY | ||||||||||||||
| VICE PRESIDENT | $152,544 | $0 | $0 | $0 | $0 | $0 | $9,093 | $0 | $22,817 | $0 | $184,454 | $0 | $0 | $0 |
| BRIAN CLARK | ||||||||||||||
| CRNA | $257,506 | $0 | $0 | $0 | $0 | $0 | $18,000 | $0 | $28,882 | $0 | $304,388 | $0 | $0 | $0 |
| CHAD BUSH | ||||||||||||||
| CRNA | $256,719 | $0 | $0 | $0 | $0 | $0 | $15,370 | $0 | $30,403 | $0 | $302,492 | $0 | $0 | $0 |
| RANDALL SMITH | ||||||||||||||
| CRNA | $252,402 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $25,232 | $0 | $277,634 | $0 | $0 | $0 |
| LEONARD DARLING | ||||||||||||||
| PHARMACY MANAGER | $140,126 | $0 | $0 | $0 | $0 | $0 | $5,605 | $0 | $22,345 | $0 | $168,076 | $0 | $0 | $0 |
| LYNETTE BURKETT | ||||||||||||||
| AUDIOLOGIST | $132,832 | $0 | $0 | $0 | $0 | $0 | $5,253 | $0 | $20,116 | $0 | $158,201 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1: | THE HOSPITAL'S MISSION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE TO OUR COMMUNITY. WE SERVE A COMMUNITY THAT HAS ONE OF THE HIGHEST UNEMPLOYMENT RATES IN THE STATE. WE EMPLOY 85% OF THE PHYSICIANS IN THE COMMUNITY, THUS PROVIDING ADEQUATE ACCESS TO OUR COMMUNITY, SPECIFICALLY MEDICAID ELIGIBLE PATIENTS. WE OPERATE 3 RURAL HEALTH CLINICS, AND WILL HAVE ONE MORE OPERATIONAL IN 2017, WHICH GREATLY ENHANCES ACCESS TO CARE. WE PROVIDE A FULL RANGE OF OB SERVICES TO THE COMMUNITY, OF WHICH OVER 60% IS MEDICAID. WE ALSO PROVIDE WELLNESS AND DIABETIC EDUCATION SERVICES TO THE COMMUNITY, AS WELL AS HOMECARE AND HOSPICE, ALL SERVICES THAT ARE HEAVILY SUBSIDIZED. IN ADDITION, THE HOSPITAL ALSO HAS AN IP REHABILITATION UNIT ON CAMPUS , AS WELL AS A WOUND CARE CLINIC. WE HAVE STARTED AN EMPLOYEE WELLNESS PROGRAM INTERNALLY, AND PLAN TO WORK WITH LOCAL EMPLOYERS TO OFFER THIS SERVICE AS WELL. FUTURE PLANS INCLUDE OFFERING MENTAL SERVICES, AND EXPANDING ORTHOPAEDICS, AND ADDING ENT SERVICES. ADDITIONALLY, WE ARE ADDING RESOURCES TO HELP THE UNINSURED NAVIGATE THE REQUIREMENTS FOR OBTAINING INSURANCE COVERAGE FOR THEIR PROBLEMS. IN THE LATTER PART OF 2016, WE ADDED A HAND SURGEON, AND WE ALSO HAVE STARTED TO WORK COLLECTIVELY WITH THE OTHER HOSPITAL IN THE COUNTY TO IMPROVE ACCESS TO CARE, AS WELL AS ADEQUATE CALL COVERAGE FROM OUR PROVIDERS. |
| Form 990, Part VI, Section A, line 3 | THE HOSPITAL USES A MANAGEMENT COMPANY TO MANAGE OPERATIONS. THEY ALSO EMPLOY THE CEO AND CFO. |
| Form 990, Part VI, Section B, line 11b | THE 990 IS PRESENTED AT THE BOARD MEETING, AND REVIEWED BY OFFICERS AND MEMBERS DURING THE MEETING AFTER THE RETURN IS FILED. |
| Form 990, Part VI, Section B, line 12c | THE COMPLIANCE OFFICE REQUIRES ANNUAL DISCLOSURE, AND COMMUNICATES TO BOARD PERIODICALLY. IF A CONFLICT OF INTEREST ARISES, THE INDIVIDUAL IS REQUIRED TO LEAVE THE ROOM WHEN DISCUSSIONS TAKE PLACE. |
| Form 990, Part VI, Section B, line 15 | THE HOSPITAL USES DATA FROM MHA TO DETERMINE THE SALARY STRUCTURE FOR EMPLOYEES. FOR THE CEO AND CFO, QHR IS THE PRIMARY SOURCE FOR COMPENSATION, WHICH MUST BE APPROVED BY THE BOARD. THE SALARY PLAN IS PRESENTED TO THE FINANCE COMMITTEE AS WELL. ALL DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES. THIS PROCESS TOOK PLACE IN 2016 AGAIN. |
| Form 990, Part VI, Section C, line 19 | POLICIES AND STATEMENTS ARE REVIEWED AT BOARD MEETINGS. IF ADDITIONAL REQUESTS ARE MADE, THIS INFORMATION IS PROVIDED AS REQUESTED. |
| Form 990, Part IX, line 11g | PURCHASED SERVICES: Program service expenses 3,258,077. Management and general expenses 4,823,309. Fundraising expenses 0. Total expenses 8,081,386. CONSULTANT FEES: Program service expenses 1,429,812. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,429,812. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THREE RIVERS HEALTH FOUNDATION | |||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 201384776 | FOUNDATION TO HOSPITAL | MI | 501(C)(3) | 12 TYPE 1 | THREE RIVERS HEALTH SYSTEM INC | Yes (1) | |
| TRAH PROPERTIES INC | |||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383366344 | PROPERTY MANAGEMENT | MI | 501(c)(3) | 12 TYPE 1 | THREE RIVERS HEALTH SYSTEM INC | Yes (1) | |
| THREE RIVERS HEALTH AUTHORITY | |||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 382317300 | HOSPITAL | MI | 501(C)(3) | 3 | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| THREE RIVERS HEALTH NETWORK | |||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383330974 | MEDICAL DATA PROCESSING | MI | N/A | C | Yes (1) |
| INTEGRATED HEALTH SYSTEMS INC | |||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383134384 | PERSONNEL MANAGEMENT | 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 | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| TRAH PROPERTIES INC | ||
| K | $254,277 | RENT PAID |
| INTEGRATED HEALTH SYSTEMS INC | ||
| O | $4,861,356 | FMV |
Comments