MYMICHIGAN MEDICAL CENTER WEST BRANCH: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MYMICHIGAN MEDICAL CENTER WEST BRANCH (EIN 46-4088182)
- Tax period
- 2015-04-01 to 2016-03-31
- Filed
- 2017-02-08
- IRS object ID
- 201740399349301219
- Schema version
- 2015v3.0
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-02-08T12:46:54-06:00 | ReturnTs |
| Tax Period End | 2016-03-31 | 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 | 600 E Front St Ste 300 | AddressLine1Txt |
| City | Traverse City | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49686 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464088182 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Tolfree Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JOHN | BusinessNameControlTxt |
| Phone | 9893453660 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2463 S M-30 | AddressLine1Txt |
| City | WEST BRANCH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48661 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT MCGRAIL | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 9893453660 | PhoneNum |
| Signature | 2017-02-07 | 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 | 2319477800 | PhoneNum |
| Preparation | 2017-02-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | 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 | WEST BRANCH REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT MCGRAIL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2463 S M-30 | AddressLine1Txt |
| City | WEST BRANCH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,395,184 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | wbrmc.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF WEST BRANCH REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 429 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $258,038 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $56,291 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $325,677 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $50,945,431 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $357,053 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $504,416 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $52,132,577 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $11,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,491,683 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $28,885,419 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $51,388,602 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $743,975 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $0 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,396,344 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $44,827,775 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,431,431 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF WEST BRANCH REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,279,529 | ExpenseAmt |
| Grant | $11,500 | GrantAmt |
| Revenue | $50,992,543 | RevenueAmt |
| Desc | PROVIDED NURSING AND PROFESSIONAL SERVICES FOR ACUTE INPATIENTS, EMERGENCY, AND OUTPATIENTS IN A RURAL AREA DURING FISCAL YEAR 2016. INPATIENT SERVICES WERE PROVIDED TO 2,571 PATIENTS TOTALING 9,909 DAYS OF CARE. 66,050 PATIENTS RECEIVED OUTPATIENT SERVICES, AND EMERGENCY ROOM VISITS TOTALED 14,870. | Desc |
| Total Program Service Expenses | $38,279,529 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | 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 | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 429 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATHARINE KOHR | PersonNm |
| Phone | 9893433228 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2463 S M-30 | AddressLine1Txt |
| City | WEST BRANCH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48661 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| ROBERT MCGRAIL | |||||||||
| PRESIDENT / CHIEF EXECUTIVE OFFICER | 40.00 | 10.00 | Yes (X) | $249,678 | $0 | $78,669 | |||
| KATHARINE KOHR | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 10.00 | Yes (X) | $176,590 | $0 | $27,879 | |||
| LANETTE LUMBARDO | |||||||||
| CHIEF NURSING OFFICER | 40.00 | 0.00 | $239,982 | $0 | $15,318 | Yes (X) | |||
| JILL JENNINGS MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $391,844 | $0 | $7,023 | Yes (X) | |||
| KENT ALLEN | |||||||||
| DIRECTOR HUMAN RESOURCES | 40.00 | 0.00 | $112,940 | $0 | $138 | Yes (X) | |||
| NICOLE GILLETTE | |||||||||
| INTERIM CHIEF NURSING OFFICER | 40.00 | 0.00 | $114,066 | $0 | $20,979 | Yes (X) | |||
| J DANIEL STONEBACK | |||||||||
| CHAIRPERSON | 10.00 | 2.00 | Yes (X) | $2,200 | $0 | $0 | Yes (X) | ||
| E ARNOLD ENGSTER | |||||||||
| SECRETARY | 5.00 | 0.00 | Yes (X) | $1,650 | $0 | $0 | Yes (X) | ||
| JACQUIE KATTERMAN | |||||||||
| TREASURER | 5.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | Yes (X) | ||
| JEFFREY GODFREY | |||||||||
| VICE-CHAIRPERSON | 5.00 | 0.00 | Yes (X) | $1,300 | $0 | $0 | Yes (X) | ||
| MARK WEBER MD | |||||||||
| TRUSTEE | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| JAMES TAMBS | |||||||||
| TRUSTEE | 2.00 | 0.00 | $100 | $0 | $0 | Yes (X) | |||
| ELIZABETH PESZKO | |||||||||
| TRUSTEE | 2.00 | 0.00 | $850 | $0 | $0 | Yes (X) | |||
| EDWARD NAPIERALA | |||||||||
| TRUSTEE /FORMER CHIEF EXECUTIVE OFFICER | 2.00 | 0.00 | $625,539 | $0 | $5,684 | Yes (X) | |||
| KEVIN ELLIOTT | |||||||||
| TRUSTEE | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| WILLIAM JENNINGS JR | |||||||||
| TRUSTEE | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| PATRICIA BURKHEISER | |||||||||
| TRUSTEE- 1ST PART OF YEAR | 2.00 | 0.00 | $650 | $0 | $0 | Yes (X) | |||
| ALAN BRUDER | |||||||||
| TRUSTEE | 2.00 | 0.00 | $900 | $0 | $0 | Yes (X) | |||
| RICHARD BACHELDER | |||||||||
| TRUSTEE | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| PATSY HARDAWAY | |||||||||
| TRUSTEE | 2.00 | 0.00 | $900 | $0 | $0 | Yes (X) | |||
| THOMAS KISH | |||||||||
| TRUSTEE | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,920,189 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $155,690 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | 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 |
|---|---|---|---|---|---|
| PHARMACY SYSTEMS INC | |||||
| 5050 BRADENTON AVE | DUBLIN | OH | 43017 | PHARMACY STAFFING & MANAGEMENT | $847,038 |
| NORTHERN MICHIGAN EMERGENCY PHYSICIANS | |||||
| PO BOX 674579 | DETROIT | MI | 48267 | EMERGENCY ROOM PHYSICIANS | $592,710 |
| AGILITY HEALTH LLC | |||||
| PO BOX 5509 | CAROL STREAM | IL | 60197 | THERAPY STAFFING & MANAGEMENT | $527,634 |
| COVENANT HEALTHCARE LAB | |||||
| 1000 HOUGHTON AVE ROOM 2531 | SAGINAW | MI | 48602 | LABORATORY TESTING SERVICES | $413,630 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| 28525 NETWORK PLACE | CHICAGO | IL | 60673 | WOUND CARE STAFFING & MANAGEMENT | $282,984 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $325,677 | RelatedOrganizationsAmt |
| Noncash Contributions | $254,493 | NoncashContributionsAmt |
| Total Contributions | $325,677 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $50,735,265 | $50,477,227 | $258,038 |
| OTHER RELATED REVENUE | 622110 | $210,166 | $210,166 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $50,945,431 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $289,036 | TotalRevenueColumnAmt |
| Exclusion | $289,036 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $561,020 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $255,870 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $305,150 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $305,150 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $305,150 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,388 | SecuritiesAmt |
| Other | $51,366 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $6,737 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,388 | SecuritiesAmt |
| Other | $44,629 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,017 | TotalRevenueColumnAmt |
| Exclusion | $68,017 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 722210 | BusinessCd |
| Total Revenue Column | $199,266 | TotalRevenueColumnAmt |
| Exclusion | $199,266 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $199,266 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,132,577 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $50,992,543 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $258,038 | UnrelatedBusinessRevenueAmt |
| Exclusion | $556,319 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,500 | TotalAmt |
| Program Services | $11,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $926,740 | TotalAmt |
| Program Services | $647,808 | ProgramServicesAmt |
| Management And General | $278,932 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,158,855 | TotalAmt |
| Program Services | $10,039,556 | ProgramServicesAmt |
| Management And General | $3,119,299 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,631,092 | TotalAmt |
| Management And General | $2,631,092 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,774,996 | TotalAmt |
| Program Services | $4,505,252 | ProgramServicesAmt |
| Management And General | $1,269,744 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,558 | TotalAmt |
| Management And General | $166,558 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,000 | TotalAmt |
| Management And General | $61,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,048,794 | TotalAmt |
| Program Services | $4,435,869 | ProgramServicesAmt |
| Management And General | $612,925 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,914 | TotalAmt |
| Management And General | $34,914 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $985,348 | TotalAmt |
| Program Services | $216,648 | ProgramServicesAmt |
| Management And General | $768,700 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,946 | TotalAmt |
| Program Services | $33,987 | ProgramServicesAmt |
| Management And General | $20,959 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $679,457 | TotalAmt |
| Management And General | $679,457 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,191,115 | TotalAmt |
| Program Services | $1,709,356 | ProgramServicesAmt |
| Management And General | $481,759 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,453 | TotalAmt |
| Program Services | $12,589 | ProgramServicesAmt |
| Management And General | $240,864 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $12,245,550 | $11,688,124 | $557,426 |
| PROVISION FOR BAD DEBTS | $3,720,916 | $3,720,916 | $0 |
| REPAIRS & MAINTENANCE | $1,875,503 | $1,205,882 | $669,621 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,567,865 | TotalAmt |
| Program Services | $52,042 | ProgramServicesAmt |
| Management And General | $1,515,823 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,388,602 | TotalAmt |
| Program Services | $38,279,529 | ProgramServicesAmt |
| Management And General | $13,109,073 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,429,415 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,145 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $5,609,425 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $127,175 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $930,208 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $486,748 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $51,033,766 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,502,789 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $20,530,977 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $402,427 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $8,163,572 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $227,668 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $487,584 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $43,396,344 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,737,274 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,140,417 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $12,580,816 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $25,369,268 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $44,827,775 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | -$1,431,431 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | -$1,431,431 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $43,396,344 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $743,975 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $24,614 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,200,020 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $539,061 | OtherCostOrOtherBasisAmt |
| Book Value | $539,061 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,769,167 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,201,956 | DepreciationAmt |
| Book Value | $11,567,211 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,036,712 | OtherCostOrOtherBasisAmt |
| Depreciation | $381,712 | DepreciationAmt |
| Book Value | $1,655,000 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,627,142 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,919,121 | DepreciationAmt |
| Book Value | $6,708,021 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,684 | OtherCostOrOtherBasisAmt |
| Book Value | $61,684 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,530,977 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| SAVINGS & MONEY MARKET ACCOUNTS | $6,918,903 | C |
| FIXED INCOME SECURITIES | $1,237,972 | F |
| ACCRUED INTEREST | $6,697 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $8,163,572 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| COST REPORT SETTLEMENT PAYABLE | $1,742,121 |
| ACCRUED POST-RETIREMENT BENEFIT | $8,619,547 |
| PENSION OBLIGATION | $15,007,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $25,369,268 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $48,053,571 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $24,614 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $24,614 | RevenueNotReportedAmt |
| Revenue Subtotal | $48,028,957 | RevenueSubtotalAmt |
| Other Revenues Not Included | $4,103,620 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,103,620 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $52,132,577 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $47,923,083 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $255,397 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $255,397 | ExpensesNotReportedAmt |
| Expenses Subtotal | $47,667,686 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,720,916 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,720,916 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $51,388,602 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | THE INTERNAL REVENUE SERVICE HAS RULED THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF MARCH 31, 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN WHICH WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| Part XI, Line 4b - Other Adjustments: | RENTAL EXPENSES -255,870. BAD DEBT EXPENSE- ADD BACK 3,720,916. INTEREST & DIVIDEND INCOME 289,036. REALIZED GAIN 23,388. CONTRIBUTIONS 325,677. OTHER 473. |
| Part XII, Line 2d - Other Adjustments: | RENTAL EXPENSES 255,870. OTHER -473. |
| Part XII, Line 4b - Other Adjustments: | BAD DEBT EXPENSE 3,720,916. |
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 |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 103 | PersonsServedCnt |
| Total Community Benefit Expns | $25,215 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,215 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,887,709 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,218,393 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,669,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03250 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 103 | PersonsServedCnt |
| Total Community Benefit Expns | $7,912,924 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,218,393 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,694,531 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03300 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 2126 | PersonsServedCnt |
| Total Community Benefit Expns | $78,179 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,159 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $60,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $49,118 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $49,118 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,822 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $34,261 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $561 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 2126 | PersonsServedCnt |
| Total Community Benefit Expns | $162,119 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $109,699 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 2229 | PersonsServedCnt |
| Total Community Benefit Expns | $8,075,043 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,270,813 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,804,230 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03520 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 48 | PersonsServedCnt |
| Total Community Benefit Expns | $708 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 260 | PersonsServedCnt |
| Total Community Benefit Expns | $1,075 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 308 | PersonsServedCnt |
| Total Community Benefit Expns | $1,783 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,783 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,720,916 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $796,276 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $20,641,790 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $21,477,472 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$835,682 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN TOLFREE HOPSITAL DBA WEST BRANCH REGIONAL MEDICAL CENTE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2463 S M-30 | AddressLine1Txt |
| City | WEST BRANCH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WBRMC.COM | WebsiteAddressTxt |
| State License | 1060000046 | 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 | JOHN TOLFREE HOSPITAL AND SUBSIDIARIES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| 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 | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.wbrmc.com/mgr-content/afa343b6b34131f8b0ccfcf8298ccf98.pdf | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.wbrmc.com/mgr-content/75186371958955946540383071257015.pdf | FAPAppAvailableOnWebsiteURLTxt |
| 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| JOHN TOLFREE HOSPITAL AND SUBSIDIARIES | Part V, Section B, Line 2: THE HOSPITAL PREVIOUSLY OPERATED AS A MUNICIPAL HEALTHCARE FACILITY, JOHN TOLFREE HEALTH SYSTEM. ON DECEMBER 31, 2015, ASSETS WERE TRANSFERRED TO A 501 C 3 CORPORATION, JOHN TOLFREE HOSPITAL. BOTH ORGANIZATIONS OPERATE(D) WITH A D/B/A WEST BRANCH REGIONAL MEDICAL CENTER. |
| JOHN TOLFREE HOSPITAL AND SUBSIDIARIES | Part V, Section B, Line 13b: THE CRITERIA USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE INCLUDE: INCOME FROM THE APPLICANT AND ALL DIRECT FAMILY MEMBERS LIVING WITHIN THE PATIENT'S HOUSEHOLD; FOR SELF EMPLOYED APPLICANTS, THE COMPANY'S MOST RECENT INCOME STATEMENT; RESOURCES FROM SAVINGS AND CHECKING ACCOUNTS, CERTIFICATES OF DEPOSIT, STOCKS, BONDS AND REAL ESTATE; RETIREMENT INCOME; 50% OF PENSION/RETIREMENT FUNDS WILL BE CONSIDERED AN ASSET; ASSETS INCLUDING HOME, CARS, BOATS, AND ANY OTHER VEHICLES; MONTHLY EXPENSES; NUMBER OF DEPENDENTS; LAST FILED FEDERAL TAX RETURN; SOCIAL SECURITY AWARD LETTER FOR SSD OR SSI. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part II, Community Building Activities: | THE HOSPITAL IS ACTIVE IN THE PROMOTION OF HEALTHLY LIFESTYLES FOR BOTH ITS EMPLOYEES AND COMMUNITY MEMBERS. DURING THE YEAR THE HOSPITAL PROVIDED COMMUNITY EDUCATION THROUGH DIABETES SUPPORT GROUPS, HEALTHY WEIGHS, AND NUTRITION SERVICES. ADDITIONALLY THE HOSPITAL DONATED 260 CASES OF WATER TO FLINT TO ASSIST WITH THE WATER CRISIS. THE HOSPITAL TAKES A LEAD ROLE IN MANY OF THESE ENDEAVORS BUT IS ALSO WILLING TO BE A SUPPORTIVE PARTNER AND TEAM MEMBER AS WELL. |
| Part III, Line 2: | THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. |
| Part III, Line 3: | THE AMOUNT OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WAS AS ESTIMATE. THIS AMOUNT WAS CALCULATED BY MULTIPLYING THE BAD DEBT EXPENSE BY 21.4%. THIS ESTIMATE IS BASED ON THE AREA POVERTY RATE AS REPORTED IN THE 2015 CENSUS STATISTICS. |
| 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 RATE 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: | THE FOLLOWING COSTING METHOD OF COST TO CHARGE RATE IS USED: MEDICARE COSTS DIVIDED BY MEDICARE CHARGES. ANY SHORTFALLS CALCULATED ARE CONSIDERED TO BE COMMUNITY BENEFIT. |
| Part III, Line 9b: | ANY PATIENT THAT IS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE RECEIVES PERSONAL ASSISTANCE AND SUPPORT IN OBTAINING THE INFORMATION NEEDED TO QUALIFY THEM FOR FULL OR PARTIAL DISCOUNTS DEPENDING ON THEIR INCOME LEVEL. IT IS, HOWEVER, THE PATIENT'S RESPONSIBILITY TO CONTACT THE PATIENT FINANCIAL COUNSELOR TO REQUEST AN APPLICATION FOR FINANCIAL ASSISTANCE. ATTEMPTS ARE ALSO MADE BY FINANCIAL ASSISTANCE PERSONNEL TO CONTACT ANY SELF PAY PATIENT IDENTIFIED TO DISCUSS PAYMENT OPTIONS AND DETERMINE IF THERE IS A NEED TO SEND THEM A FINANCIAL ASSISTANCE APPLICATION. BROCHURES ARE ALSO LOCATED THROUGHOUT THE HOSPITAL FOR THE PATIENT'S BENEFIT WHICH EXPLAIN THE FINANCIAL ASSISTANCE PROGRAM AND HOW TO APPLY. APPLICATIONS MAY ALSO BE DOWNLOADED FROM THE HOSPITAL'S WEBSITE. EVERY POSSIBLE ATTEMPT IS MADE TO HELP THE PATIENT RESOLVE THEIR ACCOUNT; HOWEVER, IF THE PATIENT DOES NOT FOLLOW THROUGH WITH THE APPLICATION PROCESS OR IS DENIED FINANCIAL ASSISTANCE, OR FAILS TO MAKE PAYMENT ON THEIR ACCOUNT, THE ACCOUNT WILL GO THROUGH THE SAME COLLECTION PROCESS AS ALL OTHER ACCOUNTS. |
| Part VI, Line 2: | WE ARE IN THE PROCESS OF COMPLETING OUR FIRST COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH WILL PROVIDE INFORMATION ON CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. COMMUNITY NEEDS ARE ALSO RECEIVED FROM OUR EMPLOYEES, MEDICAL STAFF, AND BOARD, WHO ARE ALSO MEMBERS OF THE COMMUNITIES WE SERVE. THE MICHIGAN HOSPITAL ASSOCIATION (MHA) MARKET SHARE REPORT ALSO HIGHLIGHTS AREAS OF OPPORTUNITY FOR SERVICES THAT ARE LACKING IN OUR AREA. |
| Part VI, Line 3: | PATIENTS ARE GIVEN THE FINANCIAL ASSISTANCE POLICY AND APPLICATION UPON REGISTRATION, INCLUDING A DESCRIPTION OF THE DHS WORKER ON SITE. WE HAVE AN EMPLOYED HEALTH ACCESS COORDINATOR WHOSE PRIMARY PURPOSE IS TO ASSIST UNINSURED, UNDERINSURED, AND LOW INCOME INDIVIDUALS WITH THEIR MEDICAL NEEDS. FUNDRAISERS ARE HELD TO ENABLE US TO ASSIST THESE INDIVIDUALS WITH PRESCRIPTIONS, MEDICAL SERVICES AND SUPPLIES, AND MEDICAL RELATED TRAVEL EXPENSES. AS A CERTIFIED APPLICATION COUNSELOR AND NAVIGATOR, OUR COORDINATOR ALSO ASSISTS INDIVIDUALS WITH APPLICATIONS FOR SOCIAL SECURITY DISABILITY, MEDICAID INSURANCE COVERAGE, AND COMMERCIAL INSURANCE COVERAGE UNDER THE AFFORDABLE CARE ACT. OUR HEALTH ACCESS COORDINATOR COLLABORATES WITH OTHER LOCAL CHARITIES AND GROUPS TO PROVIDE THIS ASSISTANCE. THE COORDINATOR ALSO IS A BOARD MEMBER OF A LOCAL FREE CLINIC AND THE COMMUNITY SUPPORT TEAM, WHOSE FUNCTION IS TO PROVIDE ASSISTANCE TO INDIVIDUALS WITH CATASTROPHIC ILLNESSES. DURING THIS FISCAL YEAR, 676 CLIENTS WERE SEEN. ASSISTANCE WAS PROVIDED AND/OR ARRANGED IN THE AMOUNT OF $161,009. OUR COST FOR OUR EMPLOYED INDIVIDUAL WAS $49,179. INCOME/DONATIONS RECEIVED TOTALED $18,159.WE ALSO HAD A CONTRACTED WORKER FROM THE MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES, WHO ASSISTED UNINSURED AND UNDERINSURED PATIENTS WITH MEDICAID ELIGIBILITY. CONTACT WAS MADE WITH ALL SELF-PAY PATIENTS BY MAIL, PHONE, AND AT TIMES, IN PERSON. THE GOAL IS TO SCREEN PATIENTS FOR MEDICAID PROGRAMS, ANSWER QUESTIONS, AND ASSIST WITH THE APPLICATION PROCESS. COUNSELING IS PROVIDED TO HELP INDIVIDUALS UNDERSTAND INSURANCE OPTIONS AND MAKE INFORMED DECISIONS ABOUT OBTAINING HEALTH CARE COVERAGE. MEDICAID INELIGIBLE PATIENTS ARE REFERRED TO OUR HEALTH ACCESS PROGRAM FOR POSSIBLE ASSISTANCE. DURING THIS FISCAL YEAR, 1,450 MEDICAID APPLICATIONS WERE PROCESSED, WITH 597 BEING APPROVED FOR COVERAGE. |
| Part VI, Line 4: | JOHN TOLFREE HOSPITAL D/B/A WEST BRANCH REGIONAL MEDICAL CENTER, LOCATED IN WEST BRANCH, MICHIGAN, SERVES OGEMAW COUNTY AS WELL AS PORTIONS OF ROSCOMMON, OSCODA, IOSCO, ARENAC, AND GLADWIN COUNTIES. IN THE MOST RECENT CENSUS DATA, OGEMAW COUNTY HAD A POPULATION OF 21,699. THERE WERE 9,398 HOUSEHOLDS WITH AN AVERAGE OF 2.25 PERSONS PER HOUSEHOLD. THE MEDIAN HOUSEHOLD INCOME WAS $35,850. THE POVERTY RATE IS 21.4%. |
| Part VI, Line 5: | WEST BRANCH REGIONAL MEDICAL CENTER PARTICIPATES WITH MANY ORGANIZATIONS TO ADDRESS THE ISSUES THAT AFFECT THE HEALTH OF THE COMMUNITIES WE SERVE. WE PROVIDED INTERNSHIPS TO STUDENTS OF AREA COLLEGES AND UNIVERSITIES IN THE AREAS OF NURSING, SURGICAL SERVICES, RADIOLOGY AND ULTRASOUND. COMMUNITY EDUCATION IS PROVIDED IN THE AREAS OF WEIGHT MANAGEMENT AND DIABETES EDUCATION, INCLUDING HEALTHY COOKING PRESENTATIONS, FOOT CHECK & SCREENINGS, AND INSULIN PUMP TRAINING. WE ARE ACTIVELY INVOLVED IN A BI-MONTHLY BLOOD DRIVE, WHICH HAS RESULTED IN A SIGNIFICANT INCREASE IN BLOOD DONATIONS. WE HAVE DEDICATED STAFF IN OUR HEALTH ACCESS PROGRAM TO ASSIST OUR COMMUNITY RESIDENTS IN GAINING ACCESS TO NEEDED MEDICAL SERVICES, BY HELPING THEM FILL OUT PROGRAM APPLICATIONS, AND PROVIDING ASSISTANCE WITH PRESCRIPTION, MEDICAL SERVICES AND SUPPLIES, AND MEDICAL RELATED TRAVEL EXPENSES. WE ALSO PROVIDED A LARGE SUPPLY OF FRESH WATER TO THE RESIDENTS OF FLINT, MICHIGAN, DURING THEIR RECENT WATER CRISIS. OUR RECENTLY DEVELOPED TOLFREE WELLNESS PARK AIMS TO PROMOTE HEALTH AND WELLNESS IN THE AREA. THE LANDSCAPE, OPEN TO BOTH THE PUBLIC AND THEIR PETS, FEATURES A WALKING AND BIKING TRAIL SYSTEM, OUTDOOR EXERCISE EQUIPMENT, HEALING AND TEACHING GARDENS, AND A PAVILION WITH KITCHEN AND COOKING FACILITIES. OUR ANNUAL 5K WALK/RUN IS HELD AT THE WELLNESS PARK AS WELL AS NUMEROUS COMMUNITY EDUCATION EVENTS. NEARBY SCHOOL CHILDREN ARE INVOLVED IN GROWING VEGETABLES IN THE TEACHING GARDENS, AND THEN, LEARNING HEALTHY WAYS TO COOK THE PRODUCE UPON HARVEST, ADDRESSING THE GROWING CHILD OBESITY PROBLEM. DIABETIC EDUCATION CLASSES ARE ALSO HELD IN THE WELLNESS PARK. PLANS FOR THE PARK ALSO INCLUDE DEVELOPMENT OF CARDIAC TREATMENT PROGRAMS. |
| PART VI, LINE 7: | JOHN TOLFREE HOSPITAL BECAME A 501(C)(3) AS OF JANUARY 1, 2016. NO BENEFIT REPORT WAS FILED FOR THE CURRENT YEAR. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOLFREE FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 335 E HOUGHTON AVE | AddressLine1Txt |
| City | WEST BRANCH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 383067917 | RecipientEIN |
| Cash Grant | $11,500 | CashGrantAmt |
| Purpose Of Grant | FUNDRAISING SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT MCGRAIL | ||||||||||||||
| PRESIDENT / CHIEF EXECUTIVE OFFICER | $216,289 | $0 | $0 | $0 | $33,389 | $0 | $57,384 | $0 | $21,285 | $0 | $328,347 | $0 | $0 | $0 |
| KATHARINE KOHR | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $169,081 | $0 | $0 | $0 | $7,509 | $0 | $20,658 | $0 | $7,221 | $0 | $204,469 | $0 | $0 | $0 |
| LANETTE LUMBARDO | ||||||||||||||
| CHIEF NURSING OFFICER | $220,461 | $0 | $0 | $0 | $19,521 | $0 | $0 | $0 | $15,318 | $0 | $255,300 | $0 | $0 | $0 |
| JILL JENNINGS MD | ||||||||||||||
| PHYSICIAN | $391,820 | $0 | $0 | $0 | $24 | $0 | $0 | $0 | $7,023 | $0 | $398,867 | $0 | $0 | $0 |
| EDWARD NAPIERALA | ||||||||||||||
| TRUSTEE /FORMER CHIEF EXECUTIVE OFFI | $144,446 | $0 | $0 | $0 | $481,093 | $0 | $0 | $0 | $5,684 | $0 | $631,223 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | USDA RURAL DEVELOPMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 431757115 | BondIssuerEIN |
| CUSIP | NONEAVAIL | CUSIPNum |
| Bond Issued | 2015-12-31 | BondIssuedDt |
| Issue Price | $12,700,000 | IssuePriceAmt |
| Purpose | TO CONSOLIDATE EXISTING DEBT AND PROVIDE A STATE OF THE ART MEDICAL FACILITY | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $11,053,578 | RetiredAmt |
| Total Proceeds | $12,700,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $378,181 | IssuanceCostsFromProceedsAmt |
| Unspent | $1,268,241 | UnspentAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PAVILION | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $254,493 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OF CONSTRUCTION | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | AFTER PREPARATION OF THE RETURN BY A THIRD PARTY, IT WILL BE REVIEWED BY THE CEO AND CFO. THE BOARD WILL BE NOTIFIED THAT A COPY OF THE FORM 990 IS AVAILABLE UPON REQUEST. |
| Form 990, Part VI, Section B, line 12c | A CONFLICT OF INTEREST FORM IS COMPLETED ANNUALLY AND MONITORED FOR COMPLIANCE BY ADMINISTRATION AND THE CHAIRMAN OF THE BOARD. WHEN A CONFLICT EXISTS, THE BOARD MEMBER WITH THE CONFLICT IS ALLOWED TO DISCUSS THE MATTER AT HAND, BUT IS NOT ALLOWED TO VOTE ON ANY CONFLICTED ITEM. |
| Form 990, Part VI, Section B, line 15a | THE CEO'S COMPENSATION IS SET AT MARKET VALUE, BASED ON MARKET STUDIES DONE BY A COMMITTEE OF THE BOARD OF DIRECTORS. THIS PROCESS WAS LAST UNDERTAKEN IN 2015. |
| Form 990, Part VI, Section C, line 19 | GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XI, line 9: | PENSION-RELATED CHANGES 66,013. POSTRETIREMENT BENEFIT-RELATED CHANGES 1,775,819. EQUITY TRANSFER -4,041,852. |
| FORM 990, PART XII, LINE 2C: | THE FINANCE COMMITTEE OF THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| TOLFREE FOUNDATION | ||||||||||
| 335 E HOUGHTON AVE | WEST BRANCH | MI | 48661 | 383067917 | FUNDRAISING | MI | 501(c)(3) | Line 9 | JOHN TOLFREE HOSPITAL | Yes (1) |
| HOSPICE OF HELPING HANDS INC | ||||||||||
| 322 W HOUGHTON AVE | WEST BRANCH | MI | 48661 | 382424475 | HOSPICE CARE | MI | 501(c)(3) | Line 9 | JOHN TOLFREE HOSPITAL | Yes (1) |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| TOLFREE FOUNDATION | ||
| C | $308,050 | COST |
| HOSPICE OF HELPING HANDS INC | ||
| Q | $101,808 | COST |
| TOLFREE FOUNDATION | ||
| Q | $243,394 | COST |
Comments