BEACON ALLEGAN INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- BEACON ALLEGAN INC (EIN 38-1359180)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201603199349301500
- Schema version
- 2015v2.1
- 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 K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T08:16:10-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 SUITE 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 | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381359180 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEGAN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALLE | BusinessNameControlTxt |
| Phone | 2696864280 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 LINN STREET | AddressLine1Txt |
| City | ALLEGAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49010 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | richard harning | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2696864280 | PhoneNum |
| Signature | 2016-11-10 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RICHARD HARNING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 LINN STREET | AddressLine1Txt |
| City | ALLEGAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,989,769 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.aghosp.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1944 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL IS A SHORT-TERM, ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 378 | TotalEmployeeCnt |
| Total Volunteers | 45 | TotalVolunteersCnt |
| Total Gross UBI | $9,548 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $125,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $100,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,344,574 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $37,139,056 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,733 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,692 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,100,105 | PYOtherRevenueAmt |
| CY Other Revenue | $6,599,689 | CYOtherRevenueAmt |
| PY Total Revenue | $47,573,412 | PYTotalRevenueAmt |
| CY Total Revenue | $43,847,437 | 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 | $22,466,867 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,661,211 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,108,852 | PYOtherExpensesAmt |
| CY Other Expenses | $23,522,049 | CYOtherExpensesAmt |
| PY Total Expenses | $46,575,719 | PYTotalExpensesAmt |
| CY Total Expenses | $45,183,260 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $997,693 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,335,823 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,452,322 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,131,047 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,317,283 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,639,868 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,135,039 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,491,179 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE EXCEPTIONAL, COMPASSIONATE, PERSONALIZED HEALTHCARE TO OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,250,825 | ExpenseAmt |
| Revenue | $37,139,056 | RevenueAmt |
| Desc | ANCILLARY MEDICAL SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,675,589 | ExpenseAmt |
| Revenue | $5,696,371 | RevenueAmt |
| Desc | ROUTINE MEDICAL SERVICES; CHARITY CARE PROVIDED IN 2015 WAS APPROXIMATELY $174,805 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $36,926,414 | 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 | Yes (1) | 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 | 0 | 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 | 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 | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 378 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICHARD HARNING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2696864284 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 LINN STREET | AddressLine1Txt |
| City | ALLEGAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49010 | 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 |
|---|---|---|---|---|---|---|---|---|
| STEVE MCKOWN | ||||||||
| CHAIRMAN | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN WALSTRUM MD | ||||||||
| VICE CHAIR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $197,735 | $49,842 | |
| JAMES MUENZER | ||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM CONNELL | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Matthew Antkoviak | ||||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| EDELIO COIPEL SPHR | ||||||||
| BOARD MEMBER | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Janna Tibbitts CPA | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN HARNESS | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINE HASSING | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAWN MCFALL | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS MILLER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL ANTON HODGE | ||||||||
| BOARD MEMBER | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Cyndi Cornell-Trobeck | ||||||||
| Board Member - Part Year | 1.00 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| gERALD BARBINI | ||||||||
| cEO-COMPENSATED BY QUORUM | 40.00 | 1.50 | Yes (X) | $265,574 | $0 | $68,183 | ||
| RICHARD HARNING | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 1.50 | Yes (X) | $193,644 | $0 | $51,348 | ||
| DAVID FEDERINKO | ||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 0.00 | Yes (X) | $126,819 | $0 | $49,974 | ||
| KATHY CHAPMAN | ||||||||
| CHIEF NURSING OFFICER | 40.00 | 0.00 | Yes (X) | $129,216 | $0 | $20,092 | ||
| MARK WARNER | ||||||||
| ORTHOPEDIC SURGEON | 40.00 | 0.00 | $805,947 | $0 | $63,208 | Yes (X) | ||
| TIMOTHY FULLER | ||||||||
| CRNA | 40.00 | 0.00 | $270,334 | $0 | $67,940 | Yes (X) | ||
| KENNETH WHITCOMB | ||||||||
| CRNA | 40.00 | 0.00 | $270,949 | $0 | $45,137 | Yes (X) | ||
| James Kosiur | ||||||||
| ORTHOPEDIC SURGEON | 40.00 | 0.00 | $447,614 | $0 | $31,781 | Yes (X) | ||
| MATTHEW RALPH | ||||||||
| GENERAL SURGEON | 40.00 | 0.00 | $346,077 | $0 | $10,373 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,856,174 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $197,735 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $457,878 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WEST MICHIGAN REHAB | |||||
| 576 LINN STREET | ALLEGAN | MI | 49010 | REHABILITATION SERVICES | $1,434,170 |
| EPMG | |||||
| 200 Green Rd | Ann Arbor | MI | 48105 | Emergency SERVICES | $667,676 |
| HEALOGICS WOUND CARE | |||||
| 3087 MOMENTUM PLACE | CHICAGO | IL | 60689 | MEDICAL SERVICES | $633,997 |
| Alliance HNI | |||||
| PO BOX 6600 | Newport Beach | CA | 92658 | MRI Services | $573,832 |
| Bronson Methodist Hospital | |||||
| 601 John St | Kalamazoo | MI | 49007 | HOSPITALIST | $459,800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $100,000 | RelatedOrganizationsAmt |
| Total Contributions | $100,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $37,139,056 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,139,056 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $37,139,056 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,692 | TotalRevenueColumnAmt |
| Exclusion | $8,692 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $468,768 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $278,545 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $190,223 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $190,223 | TotalRevenueColumnAmt |
| Exclusion | $190,223 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $599,953 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $599,953 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $8,960,205 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $3,263,834 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,696,371 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,696,371 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OTHER SERVICES | 900099 | $532,586 | $532,586 | |
| CAFETERIA | 722100 | $164,125 | $154,577 | $9,548 |
| GIFT SHOP | 900099 | $16,384 | $16,384 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $713,095 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,847,437 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,835,427 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $9,548 | UnrelatedBusinessRevenueAmt |
| Exclusion | $902,462 | 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 | $904,850 | TotalAmt |
| Management And General | $904,850 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,455,136 | TotalAmt |
| Program Services | $13,224,415 | ProgramServicesAmt |
| Management And General | $3,230,721 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $754,798 | TotalAmt |
| Program Services | $652,069 | ProgramServicesAmt |
| Management And General | $102,729 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,403,842 | TotalAmt |
| Program Services | $2,101,736 | ProgramServicesAmt |
| Management And General | $302,106 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,142,585 | TotalAmt |
| Program Services | $756,382 | ProgramServicesAmt |
| Management And General | $386,203 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,976 | TotalAmt |
| Management And General | $145,976 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,360 | TotalAmt |
| Management And General | $84,360 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $737 | TotalAmt |
| Management And General | $737 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,827,834 | TotalAmt |
| Program Services | $6,486,377 | ProgramServicesAmt |
| Management And General | $1,341,457 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $472,382 | TotalAmt |
| Program Services | $388,697 | ProgramServicesAmt |
| Management And General | $83,685 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $790,933 | TotalAmt |
| Program Services | $790,933 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,681,171 | TotalAmt |
| Program Services | $2,206,186 | ProgramServicesAmt |
| Management And General | $474,985 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,246 | TotalAmt |
| Program Services | $259,398 | ProgramServicesAmt |
| Management And General | $55,848 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| supplies | $4,919,219 | $4,378,398 | $540,821 |
| BAD DEBT EXPENSE | $2,991,725 | $2,991,725 | |
| repairs and maintenance | $2,152,824 | $1,769,070 | $383,754 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,139,642 | TotalAmt |
| Program Services | $921,028 | ProgramServicesAmt |
| Management And General | $218,614 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,183,260 | TotalAmt |
| Program Services | $36,926,414 | ProgramServicesAmt |
| Management And General | $8,256,846 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,834 | BOYAmt |
| EOY | $4,115 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,833,316 | BOYAmt |
| EOY | $2,530,407 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,926,501 | BOYAmt |
| EOY | $4,952,684 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,557 | BOYAmt |
| EOY | $1,163,374 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,226 | BOYAmt |
| EOY | $524,561 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,018,274 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $34,670,189 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,840,612 | BOYAmt |
| EOY | $15,348,085 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $814,038 | BOYAmt |
| EOY | $311,185 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,648 | BOYAmt |
| EOY | $202,648 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,176,590 | BOYAmt |
| EOY | $3,093,988 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,452,322 | BOYAmt |
| EOY | $28,131,047 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,324,378 | BOYAmt |
| EOY | $5,538,194 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,600,000 | BOYAmt |
| EOY | $14,060,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,277,433 | BOYAmt |
| EOY | $948,981 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,115,472 | BOYAmt |
| EOY | $2,092,693 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,317,283 | BOYAmt |
| EOY | $22,639,868 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,135,039 | BOYAmt |
| EOY | $5,491,179 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,135,039 | BOYAmt |
| EOY | $5,491,179 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,452,322 | BOYAmt |
| EOY | $28,131,047 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,335,823 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,308,037 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $737 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $737 | 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 AHA DUES IS ALLOCATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,556 | OtherCostOrOtherBasisAmt |
| Book Value | $70,556 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,727,145 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,330,968 | DepreciationAmt |
| Book Value | $11,396,177 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,971,922 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,339,221 | DepreciationAmt |
| Book Value | $3,632,701 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $248,651 | OtherCostOrOtherBasisAmt |
| Book Value | $248,651 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,348,085 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $691,340 |
| OTHER RECEIVABLES | $934,756 |
| notes from affiliates | $1,467,892 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,093,988 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| COST REPORT SETTLEMENT | $1,660,000 |
| fair value of interest rate swap agreement | $432,693 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,092,693 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL 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 FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL 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 HOSPITAL AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2012. | ExplanationTxt |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| 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 | $79,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $79,237 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,249,628 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,978,745 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$729,117 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,256,660 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,070,412 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,186,248 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09920 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,585,525 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,049,157 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,536,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,585,525 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,049,157 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,536,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,991,725 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,484,793 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,461,755 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $49,351,321 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$41,889,566 | 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 | ALLEGAN GENERAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 LINN STREET | AddressLine1Txt |
| City | ALLEGAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | M393862 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEGAN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | FULL WEBSITE LISTED IN "OTHER" | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.AGHOSP.ORG/SITES/WWW/UPLOADS/FILES/DOWNLOADS/COMMUNITY%20HEALTH | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 | 150.000000000000 | 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 |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | www.aghosp.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.aghosp.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.aghosp.org | 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 |
| 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 |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ALLEGAN GENERAL HOSPITAL | Part V, Section B, Line 5: IN CONDUCTING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, ALLEGAN GENERAL HOSPITAL CONSULTED WITH 3 INDIVIDUALS FROM ALLEGAN COUNTY HEALTH DEPARTMENT DURING JANUARY 2013 KICK-OFF MEETINGS: 1) RICHARD TOOKER, M.D., M.P.H., MEDICAL DIRECTOR; 2) RASHMI TRAVIS, M.P.H., HEALTH OFFICER; 3) ANGELIQUE JOYNES, R.N.ADDITIONALLY, ALLEGAN GENERAL HOSPITAL MET WITH LEADERS FROM OTHER COMMUNITY ORGANIZATIONS DURING JANUARY 2013 KICK-OFF MEETINGS, INCLUDING ALLEGAN COUNTY UNITED WAY, ALLEGAN COUNTY TRANSPORTATION, MI PATHWAYS, ALLEGAN COUNTY SENIOR SERVICES, AND ALLEGAN COUNTY COMMUNITY MENTAL HEALTH.A COMMUNITY SURVEY WAS CONDUCTED TO GAIN ADDITIONAL INSIGHT INTO HEALTH STATUS AND PERCEPTION OF HEALTH NEEDS. A TOTAL OF 196 COMMUNITY MEMBERS RESPONDED TO THE SURVEY.A BROAD CROSS-SECTION OF COMMUNITY LEADERS WAS INVITED TO PARTICIPATE IN A PRIORITY-SETTING MEETING IN APRIL 2013, SEE BELOW FOR LIST OF TWENTY-FIVE ATTENDEES FROM EIGHTEEN ORGANIZATIONS:CHRISTINE ARMINTROUT - COMMUNITY EDUCATION COORDINATOR AT WINGS OF HOPE HOSPICENORA BALGOYEN-WILLIAMS - MANAGER OF MICHIGAN WORKS AT ALLEGAN AREA EDUCATIONAL SERVICE AGENCYTHERESA BRAY - CEO AT ALLEGAN COUNTY COMMUNITY FOUNDATIONTERRY BURNS - THERAPIST AT LAKESHORE COUNSELING SERVICEPENNY BURSMA - PROGRAM OFFICER AT PERRIGO FOUNDATIONLINDA CLARK - CHAIR AT ALLEGAN AREA ARTS COUNCILTOM CLARK - MEMBER, CITY COUNCIL FOR CITY OF ALLEGANCHARLIE COOK - SAFE HOUSE MANAGER AT SYLVIA'S PLACESARA DECKER - BUSINESS MANAGER AT BRIARWOOD ASSISTED LIVINGHEATHER FORREST - EXECUTIVE DIRECTOR AT SYLVIA'S PLACEMIMI GABRIEL - EXECUTIVE DIRECTOR AT ALLEGAN COUNTY UNITED WAYKAREN HANCOCK - CAMPAIGN MANAGER FOR ALLEGAN COUNTY UNITED WAYCHRISTINE HASSING - DIRECTOR OF DEMAND MANAGEMENT AT PERRIGO COMPANY/AGH BOARD OF DIRECTORSBILL HEKKER - ADMINISTRATION AT ALLEGAN COUNTY MEDICAL CARE COMMUNITYBRAD KERBER - PHYSICAL THERAPY ASSISTANT AT WEST MICHIGAN REHABILITATIONSARAH LACHAPELLE - DIRECTOR OF ALLEGAN COUNTY HEAD STARTBETTY MCDANIEL - MAYOR OF CITY OF ALLEGANCOLLEEN SANCHEZ - DIRECTOR OF ALLEGAN COUNTY EARLY HEAD STARTLAURIE SCHMITT - ASSISTANT SUPERINTENDENT OF ALLEGAN AREA EDUCATIONAL SERVICE AGENCYBART SHAW - RETIRED FROM AGH FOUNDATION BOARD/DRUG COURTSHEILA SHAW - RETIREDLOVEDIA STAP - BRANCH MANAGER OF CHEMICAL BANKRASHMI TRAVIS - HEALTH OFFICER AT ALLEGAN COUNTY HEALTH DEPARTMENTSANDRA TULEJA - FAMILY SERVICES SPECIALIST FOR ALLEGAN COUNTY HEAD STARTAMI VASQUEZ - GREAT START COLLABORATION DIRECTOR FOR ALLEGAN AREA EDUCATIONAL SERVICE AGENCY |
| ALLEGAN GENERAL HOSPITAL | Part V, Section B, Line 7d: FROM LINE 5A: https://www.aghosp.org/sites/www/Uploads/files/Downloads/Community%20Health%20Needs%20Assessment.pdf |
| ALLEGAN GENERAL HOSPITAL | Part V, Section B, Line 11: WHILE THE CHNA IDENTIFIED OTHER HEALTH NEEDS, THEY WERE SEEN TO BE BEYOND THE SCOPE OF OUR SERVICES OR WE COULD NOT MAKE A SIGNIFICANT IMPACT UPON THEM DUE TO LIMITED PERSONNEL AND/OR FINANCIAL RESOURCES. |
| ALLEGAN GENERAL HOSPITAL | Part V, Section B, Line 13b: THE HOSPITAL USES INCOME LEVELS, NUMBER OF DEPENDENTS, AND PATIENTS GUARANTORS AS FACTORS. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | THE COST TO CHARGE RATIO IS USED TO CALCULATE COMMUNITY BENEFIT. |
| 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 $ 2,991,725. |
| Part II, Community Building Activities: | WELLNESS PROGRAMS AND SPIRIT OF WOMEN OUTREACH PROGRAMS |
| 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. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. |
| Part III, Line 8: | THE ESTIMATED MEDICARE SHORTFALL IS BASED ON THE COST TO CHARGE METHODOLOGY OF THE UNREIMBURSED COST OF CARE. ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT AS MOST OF THESE PATIENTS ARE LIVING ON FIXED INCOMES AND DO NOT HAVE THE ABILITY TO HELP COVER THE COST OF THEIR MEDICAL CARE. THE MEDICAL FACILITY HAS TO ABSORB THESE COSTS AND IT IS DONE SO AS A BENEFIT TO THE COMMUNITY. |
| Part III, Line 9b: | WHEN FINANCIAL ASSISTANCE PATIENTS ARE IDENTIFIED, COLLECTION ACTIVITY IS STOPPED AND THEIR ACCOUNTS ARE PLACED ON HOLD PENDING COMPLETION AND RETURN OF ALL REQUIRED DOCUMENTS. THE IDENTIFICATION CAN OCCUR AT PRE-REGISTRATION, DURING AN ADMISSION OR AFTER A PATIENT HAS RECEIVED A BALANCE OWING STATEMENT. THE APPROPRIATE PERCENTAGE OF DISCOUNT IS DETERMINED ONCE ALL INFORMATION IS RECEIVED BY THE HOSPITAL. THE ACCOUNTS INVOLVED WITH THE FINANCIAL ASSISTANCE ARE THEN REVIEWED, APPROVED, AND CREDIT ADJUSTMENTS POSTED TO THE ACCOUNTS. ANY ACCOUNTS THAT MAY HAVE A REMAINING BALANCE AFTER DISCOUNTING ARE RELEASED FROM HOLD AND THE PATIENT IS BILLED. |
| Part VI, Line 2: | THE ORGANIZATION USES VARIOUS SURVEYS TO OBTAIN INFORMATION REGARDING THE NEEDS OF THE COMMUNITY. |
| Part VI, Line 3: | OUR IN-HOUSE FINANCIAL COUNSELOR EDUCATES AND WORKS WITH PATIENTS TO GET FEDERAL ASSISTANCE OR TO APPLY FOR MEDICAID |
| Part VI, Line 4: | ALLEGAN GENERAL HOSPITAL IS LOCATED IN ALLEGAN, MICHIGAN, THE COUNTY SEAT OF ALLEGAN COUNTY. ALLEGAN COUNTY IS APPROXIMATELY 40 MILES SOUTH OF GRAND RAPIDS, 80 MILES WEST OF LANSING AND 70 MILES NORTH OF SOUTH BEND, INDIANA. IN ADDITION TO THE HOSPITAL, OTHER MAJOR EMPLOYERS INCLUDE: PERRIGO COMPANY (3,200 EMPLOYEES), HAWORTH INC. (3,000 EMPLOYEES), PARKER HANNIFIN CORP. (700 EMPLOYEES), S 2 YACHTS INC. (600 EMPLOYEES), AND VENTUREDYNE CORP. (500 EMPLOYEES). ALLEGAN COUNTY HAS A TOTAL POPULATION OF APPROXIMATELY 105,000. APPROXIMATELY 39% OF THIS POPULATION IS OVER THE AGE OF 45, WITH 12% OVER THE AGE OF 65, WHICH IS IN LINE WITH THE STATE OF MICHIGAN AVERAGES OF 39% AND 13% RESPECTIVELY. ALLEGAN COUNTY'S POPULATION IS RELATIVELY YOUNG. AS THE POPULATION AGES, THE HOSPITAL SHOULD SEE AN OVERALL INCREASE IN PATIENT CARE DEMAND. ALLEGAN COUNTY'S MEDIAN HOUSEHOLD INCOME IN 2008 WAS $52,401, WHICH IS HIGHER THAN THE STATE AVERAGE OF $49,694 AND THE NATIONAL AVERAGE OF $52,175. |
| Part VI, Line 5: | THE HOSPITAL'S MISSION IS TO PROVIDE EXCEPTIONAL, COMPASSIONATE, PERSONALIZED HEALTHCARE TO OUR COMMUNITY. THE HOSPITAL'S VISION IS TO BE THE TRUSTED HEALTHCARE PROVIDER OF CHOICE BY DEMONSTRATING CLINICAL AND OPERATIONAL EXCELLENCE, OUTSTANDING CUSTOMER SERVICE AND AN UNWAVERING COMMITMENT TO THE HEALTH OF OUR COMMUNITY. |
| Part VI, Line 7, Reports Filed With States | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN WALSTRUM MD | ||||||||||||||
| VICE CHAIR | $0 | $197,735 | $0 | $0 | $0 | $0 | $0 | $22,490 | $0 | $27,352 | $0 | $247,577 | $0 | $0 |
| gERALD BARBINI | ||||||||||||||
| cEO-COMPENSATED BY QUORUM | $265,574 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $68,183 | $0 | $333,757 | $0 | $0 | $0 |
| RICHARD HARNING | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $193,644 | $0 | $0 | $0 | $0 | $0 | $5,850 | $0 | $45,498 | $0 | $244,992 | $0 | $0 | $0 |
| DAVID FEDERINKO | ||||||||||||||
| CHIEF INFORMATION OFFICER | $126,819 | $0 | $0 | $0 | $0 | $0 | $15,600 | $0 | $34,374 | $0 | $176,793 | $0 | $0 | $0 |
| MARK WARNER | ||||||||||||||
| ORTHOPEDIC SURGEON | $805,947 | $0 | $0 | $0 | $0 | $0 | $24,000 | $0 | $39,208 | $0 | $869,155 | $0 | $0 | $0 |
| TIMOTHY FULLER | ||||||||||||||
| CRNA | $270,334 | $0 | $0 | $0 | $0 | $0 | $24,000 | $0 | $43,940 | $0 | $338,274 | $0 | $0 | $0 |
| KENNETH WHITCOMB | ||||||||||||||
| CRNA | $270,949 | $0 | $0 | $0 | $0 | $0 | $23,166 | $0 | $21,971 | $0 | $316,086 | $0 | $0 | $0 |
| James Kosiur | ||||||||||||||
| ORTHOPEDIC SURGEON | $447,614 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $31,781 | $0 | $479,395 | $0 | $0 | $0 |
| MATTHEW RALPH | ||||||||||||||
| GENERAL SURGEON | $346,077 | $0 | $0 | $0 | $0 | $0 | $10,373 | $0 | $0 | $0 | $356,450 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII, LINE 1A | FormAndLineReferenceDesc |
| Explanation | GERALD BARBINI IS COMPENSATED BY QUORUM, AN UNRELATED ORGANIZATION, AS CEO OF ALLEGAN GENERAL HOSPITAL. HIS TOTAL REPORTABLE COMPENSATION WAS $265,574. | ExplanationTxt |
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 | CITY OF ALLEGAN HOSPITAL FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 386004518 | BondIssuerEIN |
| CUSIP | NONEAVAIL | CUSIPNum |
| Bond Issued | 2010-12-20 | BondIssuedDt |
| Issue Price | $17,000,000 | IssuePriceAmt |
| Purpose | REFUNDING AND CONSTRUCTION OF HOSPITAL FACILITIES | 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 | $1,880,000 | RetiredAmt |
| Total Proceeds | $17,000,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $278,475 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $5,176,300 | CapitalExpendituresAmt |
| Other Spent Proceeds | $2,885,156 | OtherSpentProceedsAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | 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 |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | 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 | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FIFTH THIRD BANK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 6.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| 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 | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | THE CEO IS CONTRACTED OUT FROM A PROFESSIONAL STAFFING FIRM. |
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY THE CFO. ANY REPORTABLE INFORMATION IS SHARED WITH THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Section B, line 12c | THE CONFLICT OF INTEREST PROCESS IS THAT BOARD MEMBERS AND THE LEADERSHIP TEAM ARE EXPECTED TO COMPLETE THE DISCLOSURE STATEMENTS ANNUALLY. THESE ARE REVIEWED BY THE COMPLIANCE OFFICER FOR ANY POTENTIAL ISSUES AND DISCUSSED WITH INDIVIDUAL BOARD MEMBERS AS NECESSARY. IF A MATERIAL CONFLICT IS IDENTIFIED, MEASURES ARE TAKEN TO MITIGATE THE CONFLICT. IF NECESSARY, EXTERNAL LEGAL COUNSEL WILL BE CONSULTED. |
| Form 990, Part VI, Section B, line 15 | A REVIEW IS PERFORMED COMPARING CURRENT COMPENSATION TO EXTERNAL WAGE SURVEYS ON MARKET RATES. ADDITIONALLY, AN INDEPENDENT COMPENSATION CONSULTANT IS USED AND THE BOARD CONDUCTS A STUDY TO DETERMINE COMPENSATION. ALL DECISIONS ARE DOCUMENTED IN WRITTEN CONTRACTS AND THE BOARD MINUTES. THIS PROCESS IS PERFORMED ANNUALLY. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2014. |
| Form 990, Part VI, Section C, line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| Form 990, Part IX, line 11g | PROFESSIONAL FEES: Program service expenses 1,681,449. Management and general expenses 306,971. Fundraising expenses 0. Total expenses 1,988,420. PURCHASED SERVICES: Program service expenses 4,505,388. Management and general expenses 969,996. Fundraising expenses 0. Total expenses 5,475,384. OTHER FEES: Program service expenses 299,540. Management and general expenses 64,490. Fundraising expenses 0. Total expenses 364,030. |
| Form 990, Part XI, line 9: | CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENT 191,963. TRANSFER TO APHS -2,500,000. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGES IN PROCESS FROM 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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALLEGAN HEALTHCARE GROUP | |||||||||||
| 555 LINN STREET | ALLEGAN | MI | 49010 | 382802463 | HOSPITAL | MI | 501(c)(3) | Line 11a, I | N/A | 0 | |
| ALLEGAN PROFESSIONAL HEALTH SERVICES | |||||||||||
| 555 LINN STREET | ALLEGAN | MI | 49010 | 205800012 | HEALTHCARE | MI | 501(c)(3) | Line 3 | Yes (1) | ALLEGAN HEALTHCARE GROUP | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEGAN GENERAL HOSPITAL PAIN ADMINISTRATION SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 LINN STREET | AddressLine1Txt |
| City | ALLEGAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473706652 | EIN |
| Primary Activities | PAIN MGMT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEGAN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | investment | PredominantIncomeTypeTxt |
| Share Of Total Income | $21,323 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $105,710 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH CENTERS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 LINN STREET | AddressLine1Txt |
| City | ALLEGAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382677756 | EIN |
| Primary Activities | MEDICAL SERVICE | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ALLEGAN PROFESSIONAL HEALTH SERVICES | ||
| R | $2,500,000 | CASH |
| ALLEGAN HEALTHCARE GROUP INC | ||
| C | $100,000 | CASH |
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