2016-01-11T12:20:23-06:00 2015-02-28 990 2014-03-01 381218485 CareLink of Jackson a Community-Owned Specialty Hospital CARE 5177871440 110 North Elm Avenue Jackson MI 49202 Dale L Friesen Chief Financial Officer 5177871440 2016-01-05 2014 2016-04-25 22:37:26Z J Mark Fall 110 North Elm Avenue Jackson MI 49202 15418449 0 X www.carelinkofjackson.org X 2003 MI To provide long-term acute healthcare to the residents of Jackson, MI and surrounding areas. 7 4 192 1 0 0 13415 17715 15795945 15306833 299 -253 257874 84716 16067533 15409011 0 0 0 0 6905485 6534912 0 0 0 8943664 8531746 15849149 15066658 218384 342353 6551926 6976567 2641905 2864173 3910021 4112394 X CareLink of Jackson is committed to holistic care of individuals with complex medical needs. 0 0 12441290 15349760 Carelink of Jackson is a long-term acute care hospital fully accredited by The Joint Commission. The facility is designed and managed to provide care for medically complex patients requiring an average hospital stay in excess of 25 days. Any patient having an acute chronic condition, complication from a surgical procedure or expected to require a longer acute hospital stay may be considered for admission.Carelink of Jackson is a free-standing hospital whereby patients are accepted from multiple sources. Patients are frequently referred to Carelink of Jackson from other acute care hospitals, skilled nursing facilities, physician offices, wound clinics, dialysis centers and others.During the fiscal year ended 02/28/15, Carelink of Jackson maintained an average daily census of 31.2 patients and provided 11,385 days of patient care. Due to the complex medical needs of patients served by the hospital, the average patient resided at the facility for 25.8 days. Approximately 83.7% of all discharged patients were Medicare eligible. 12441290 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 19 0 1 192 1 0 0 0 0 0 0 0 0 0 0 X 7 4 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Dale L Friesen 5177964475 110 North Elm Avenue Jackson MI 49202 George Hunter Secretary 1.00 59.00 X X 0 274449 17833 Ondrea Bates Trustee 1.00 59.00 X 0 286382 38089 Karen Chaprnka Trustee thru 12/18/14 1.00 59.00 X 0 469550 31903 Brent Ellis Chairman 5.00 0.00 X 0 0 0 Michael K Falahee Trustee 1.00 0.00 X 0 0 0 Maryanne Fuchs Trustee 1.00 0.00 X 0 0 0 Gregg Patten MD Trustee/Medical Staff 1.00 2.00 X 0 0 0 David Schmidt Trustee 1.00 0.00 X 0 0 0 J Mark Fall CEO 50.00 0.00 X 0 0 0 Dale Friesen CFO 50.00 0.00 X 0 0 0 0 1030381 87825 0 0 1 0 Greentree Healthcare Partners LLC 110 Johnston Farm Lane Woodstock GA 30188 Management Services 860221 Pulmonary Clinics of Southern Michigan 900 E Michigan Avenue Jackson MI 49201 Healthcare Services 327924 Fresenius Management Services Inc 16343 Collections Center Drive Chicago IL 60693 Healthcare Services 183089 3 17715 17715 Patient Service 621990 15306833 15306833 15306833 1714 1714 49260 7471 41789 41789 41789 1967 -1967 -1967 -1967 Dietary Cafeteria 722210 39785 39785 Miscellaneous 900099 3142 3142 42927 15409011 15349760 0 41536 X 5459316 4863856 595460 81204 73084 8120 604759 544283 60476 389633 350670 38963 873096 873096 26958 26958 41240 41240 3084 3084 3499294 2649505 849789 6322 6322 1286464 1216404 70060 60780 60780 335029 335029 73656 25912 47744 32 32 338442 338442 40559 36503 4056 Pharmaceuticals 1625008 1625008 Food 179698 179698 Medical Supplies 142084 142084 15066658 12441290 2625368 0 199844 225043 1158501 2514863 2677616 1906714 75801 66554 6717373 4534838 2359468 2182535 80696 80858 6551926 6976567 317699 491966 2324206 2372207 2641905 2864173 X 3910021 4112394 3910021 4112394 6551926 6976567 X 342353 -139980 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3084 3084 0 Part II-B, Line 1: CareLink of Jackson pays membership dues to several non-profit advocacy groups including the Michigan Hospital Association. These organizations use a portion of membership dues to lobby for causes related to CareLink of Jackson's exempt mission. 198058 198058 4657664 3318384 1339280 1774965 1216454 558511 86686 86686 2182535 Cost Report Settlement Payable 464581 Payable to Affiliate 1429079 Compensation Amounts Withheld 478547 2372207 15416481 0 15416481 -7470 -7470 15409011 15074128 7470 7470 15066658 0 15066658 Part XI, Line 4b - Other Adjustments: Rental expenses netted against rental income Part XII, Line 2d - Other Adjustments: Rental expense netted against rental income Schedule D, Page 4, Part XI, Line 4b and Part XII, Line 2d Differences in audited financial and tax revenues and expenses are explained by a number of factors. These factors include but are not limited to equipment losses and rental expenses reported as expenses in the audited financial purposes. For tax returns, these amounts are moved to the revenue page of the Form 990 and netted against the appropriate revenue amount. 1 1 1 X 1 X 1 1 0 0 235106 235106 0.01560 235106 235106 0.01560 25567 25567 0.00170 2725 2725 0.00020 28292 28292 0.00190 263398 263398 0.01750 725 725 0.00000 725 725 0.00000 60 60 0.00000 1510 1510 0 201068 0 9379852 10269782 -889930 X 1 1 1 1 CareLink of Jackson 110 North Elm Avenue Jackson MI 49202 www.carelinkofjackson.org X Long-term acute care hospital CareLink of Jackson 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X http://www.carelinkofjackson.org X 1 13 1 www.myhio.org 1 0 1 X 200.000000000000 350.000000000000 X X 1 1 X X X 1 X X X 1 0 X X X 0 X X 0 0 CareLink of Jackson Part V, Section B, Line 5: Individuals contributing input for CareLink of Jackson's recent CHNAMegan Albertson, Allegiance HealthKellie Baker, LifeWaysMarilyn Bell, Michigan Purchasers Health AllianceSara Benedetto, Center for Family Health Adam Brown, Jackson County AdministrationCindy Bruner, Meridian Health PlanShelly Bullinger, Jackson County Health DepartmentKathleen Clark, YMCA Storer CampsMark Fall, CareLink of JacksonAndrew Farmer, AARP of MichiganKevin Ford, MSUTed Hilleary, Community MemberJennifer Johnson, Great Lakes IndustryDavid King, LifeWaysRay King, Allegiance HealthDavid Kirk, Allegiance HealthIrene LeCrone, United WayKatie Luke, Partnership Park Neighborhood Assoc.Katherine Martin, Community Action AgencyRebecca Mayer, AWAREPamela McCrum, Catholic Charities of Jackson Dani Meier, Jackson Public SchoolsMonica Moser, Jackson Community Foundation Wendy Murdock, United Way of Jackson CountyErin Norton, United WayAmy Pelletier, Marriage MattersRhonda Rudolph, Jackson County Health DepartmentScott Schmidt, United Way of Jackson County Amy Schultz, Allegiance HealthSteve Sukta, Intermediate School DistrictScott TenBrink, Fitness Council of Jackson Shaina Tinsey, Allegiance HealthJulie Weisbrod, Jackson County Health DepartmentTed Westmeier, Jackson County Health Department CareLink of Jackson Part V, Section B, Line 6a: W.A. Foote Memorial Hospital dba Allegiance Health CareLink of Jackson Part V, Section B, Line 11: On June 26, 2014, the Carelink of Jackson Board of Trustees adopted the Carelink of Jackson Community Health Needs Assessment (CHNA). During the ensuing months, an Implementation (Action) Plan was developed for purposes of addressing various community health needs identified within the CHNA. The actions and strategies outlined in the Implementation Plan are scheduled for execution from the present to 2020. As of February 28, 2015 (i.e. the Company's fiscal year-end), the Community Health Needs Assessment had been finalized for only eight (8) months. As such, management personnel remained engaged in ongoing refinement of the resultant Implementation Plan.It is anticipated that formal actualization of the Implementation Plan will commence in the fiscal year ended February 29, 2016. Specifically, it is anticipated that Carelink of Jackson will collaborate with several partner organizations in execution of the Implementation (Action) Plan. CareLink of Jackson Part V, Section B, Line 22d: The hospital facility uses the Medicare rate as the maximum amounts that can be charged to FAP-eligible individuals. Part I, Line 6a: The Hospital prepares an annual community benefit report, which can be accessed at allegiancehealth.org/givingback. Part II, Community Building Activities: Both the organization and its affiliated healthcare entities exist for the purpose of addressing the healthcare needs of the local community. The governing bodies of the affiliated entities maintain significant representation from the local community to ensure overall community awareness, sensitivity and response. As a long-term acute care hospital, CareLink of Jackson serves as a unique discharge destination for medically complex patients upon discharge from the affiliated short-term acute care hospital (i.e. brother/sister entity). Patients admitted to CareLink of Jackson are typically not appropriate admission candidates to either skilled nursing facilities or their personal residence. Accordingly, CareLink of Jackson provides an intermediate source of specialized medical care not typically available in other communities. Part III, Line 2: 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. Part III, Line 4: Note I - Nature of Business and Significant Accounting PoliciesAccounts Receivable - Accounts receivable for patients, insurance companies, and governmental agencies are based on gross charges. Accounts receivable are reduced by an allowance for contractual adjustments, which is based on expected payments from payers based on current reimbursement methodologies. Accounts receivable are also 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 payers 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. Uncollectible amounts are written off against the allowance for doubtful accounts in the period they are determined to be uncollectible. Part III, Line 8: The organization believes the entire shortfall reported on Line 7 should be treated as Community Benefit. CareLink of Jackson is subsidizing a government program and sustaining material losses in providing health care to Medicare recipients. Part III, Line 9b: The collection practices employed by CareLink of Jackson include telephone contact with Third-Party payors, a series of letters and telephone contacts with individual patients, and, if necessary, submission of the claim to a third-party collection agency. Part VI, Line 2: CareLink and other community partners conduct a telephone survey every three years in order to gather information on the health status of Jackson County. Through a statistically valid survey, we collect responses from over 1,000 Jackson County residents age 18 and older to a 180 question survey about their health status, insurance coverage, personal health habits and health care experiences. The specific steps involve collecting and analyzing health information for our County (including subpopulations within our County); measuring our health status against other communities, the state and the nation; prioritizing health issues within the community; creating a system for sharing this data with community organizations and residents; initiating strategic planning to address these issues through collaborative activities; and monitoring impact of health initiatives on community health outcomes. Part VI, Line 3: Patients are notified of potential eligibility for financial assistance under federal and state programs as well as the company's charity care policy. Patients are informed via direct communication with the patient account coordinator, the case manager, or various other hospital personnel. Where appropriate, patients receive an application for charity care that is to be submitted for review by the finance department. Part VI, Line 4: CareLink of Jackson population is determined geographically by the boundaries of Jackson County and various surrounding communities. As a subsidiary of Allegiance Health, a tax exempt Health System, CareLink helps serves the collective health needs of the more than 160,000 residents of Jackson County. The gender distribution of Jackson County residents is 49% female and 51% male.The age distribution of Jackson County is 26% of residents 19 years and under, 18% between 20 and 34 years, 29% between 35 and 54 years, 13% between 55 and 64 years, and 14% of residents are 65 years and older. Racial distribution of Jackson County residents according to the 2011 Census Data is 88.0% as white, 7.9% as African American, 0.7% as Asian, 0.4% as American Indian or Alaska Native, and 3.0% as some other race or two or more races. Of males aged 15 years and over, 33.0% have never married, 50.3% are married, 1.5% are separated, 2.9% are widowed, and 12.3% are divorced. Of females aged 15 and over, 25.0% have never married, 50.3% are married, 1.7% are separated, 9.8% are widowed, and 13.2% are divorced. According to the Bureau of Labor Statistics (2013), Jackson County also experiences a high unemployment rate of 8.8%. With 69,400 individuals in the civilian labor force, 6,100 residents are currently unemployed. Of those employed, major industries represented include educational services, health care, and social assistance (23.9%); manufacturing (18.7%); retail trade (12.1%); professional, scientific, management, administrative, and waste management services (7.7%); and arts, entertainment, recreation, accommodation, and food services (7.5%). Part VI, Line 6: The Hospital's sole corporate member is Allegiance Health Services, a 501(c)(3) organization. Other affiliates include a Hospital with a 24 hour emergency room, Foundation, a Hospice, a Volunteer Organization and a Home Health Care company, all 501(c)(3) organizations. Additionally, the hospital recently formed a clinically integrated network.The Hospital, Hospice, LTACH and Home Health Care organization work together to provide necessary medical services to the Jackson Community. The Foundation and the Volunteer Organization work closely with the Parent and the Hospital in raising funds for projects and services that would benefit the overall well-being of the community. The most recent campaign is raising funds for a Graduate Medical Education program. Previous campaigns successfully raised funds to expand and improve our cancer care service line and provided free medical care to indigent patients. The clinically integrated network works to improve patient clinical outcomes thru coordinated care and lowering overall health care costs. 0 1 0 0 0 0 0 0 0 George Hunter Secretary 0 233915 0 35300 0 5234 0 6388 0 11445 0 292282 0 0 Ondrea Bates Trustee 0 237387 0 48234 0 761 0 11429 0 26660 0 324471 0 0 Karen Chaprnka Trustee thru 12/18/14 0 353518 0 72847 0 43185 0 19637 0 12266 0 501453 0 18242 Part I, Line 3 CareLink of Jackson does not pay compensation to its CEO. CareLink contracts with Greentree Healthcare Partners for the services of the CEO. Part I, Line 4b Certain CareLink of Jackson Trustees participated in a non-qualified deferred compensation plan through their employment as officers of Allegiance Health, a related tax-exempt organization. The calendar year 2014 contribution and distribution amounts are as follows: 457(f) Contributions Ondrea Bates $9,663 Karen Chaprnka $17,687, George Hunter $5,522 457(f) Distributions Karen Chaprnka $18,242, Greentree Healthcare Partners LLC Contractor 873096 Reported amount is for payments made by CareLink of Jackson to Greentree Healthcare Partners for outsourced management services. J. Mark Fall, a CareLink of Jackson Officer, is a partner in Greentree Healthcare Partners. 0 Pulmonary Clinics of Southern Michigan Contractor 214993 Reported amount is for payments CareLink of Jackson made to Pulmonary Clinics of Southern Michigan for healthcare services. Trustee Gregg Patten is a part-owner of Pulmonary Clinics of Southern Michigan. 0 Form 990, Part VI, Section A, line 3 Officers of the Organization are employed by a management company. See Part VII, Section B, Independent Contractors. Form 990, Part VI, Section A, line 6 The Corporation is organized on a member basis. The sole corporate member of the Corporation is Allegiance Health Services. Form 990, Part VI, Section A, line 7a Member has the power to approve changes in those provisions of the Corporations Bylaws which affect the size, composition, and method of selection of the Board of Directors. Member has the power to elect and remove, with or without cause, the Corporation's Directors. Form 990, Part VI, Section A, line 7b Member has the power to approve any change in the Articles of Incorporation, purposes or philosophy of the Corporation; Approve plans of merger, consolidation or dissolution of the Corporation. Authorize the sale, lease, mortgage or other disposition of all or substantially all of the assets owned, held or leased by or to the Corporation. Ratify or reject operating and capital budgets developed by the Board and any non budgetary expenditures or creations of debt in excess of an amount designated by the Member from time to time. Authorize the formation or acquisition of new subsidiaries of the Corporation or the sale or other disposition of existing subsidiaries. Select the auditors for the Corporation. The Member may also take action without a meeting. Any action required or permitted to be taken at an annual or special meeting of the Member of the Corporation, may be taken without a meeting, without prior notice, and without a vote, if a consent in writing, setting forth the action so taken, is signed by the Member of the Corporation. Form 990, Part VI, Section B, line 11 Form 990 is reviewed by CareLink's CFO and Allegiance Health's Director of Finance. Allegiance Health is a related tax exempt organization. Final copies of the return are distributed to CareLink's Board of Directors and CEO for review before the return is filed. Form 990, Part VI, Section B, line 12c CareLink of Jackson has adopted Allegiance Health's conflict of interest policy. Paragraph below details how Allegiance Health's policy regularly and consistently monitors and enforces compliance with the conflict of interest policy. The Board Compliance Committee has ultimate responsibility over the enforcement of the Hospital's Conflict of Interest Policy. When a potential conflict of interest is identified, the Compliance Committee is responsible for review of the conflict of interest for compliance with the policy. Also, General Counsel routinely reviews upcoming Board and Committee meeting agendas to assess potential conflict situations. All employees are required to complete a conflict of interest statment. Trustees, directors, and key employees are required to fill out an annual conflict of interest questionnaire. Board Trustees identified as having a conflict of interest are permitted to discuss the potential transaction. They are not allowed to deliberate in the decision or vote on the matter. Form 990, Part VI, Section B, line 15 CareLink of Jackson is managed by a third party consulting group. This contract is reviewed and approved annually by the Board of Trustees. Employees of the outside consulting group do not have a vote in approving the contract. Form 990, Part VI, Section C, line 19 The Organization's governing documents are available to the public upon request and also on the State of Michigan website. Form 990 is available upon request. The Form 990 is also available on the free website www.guidestar.org. The Organization's conflict of interest policy is not available to the public. Form 990, Part IX, line 11g Healthcare Purchased Services: Program service expenses 2,649,505. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,649,505. Administrative Purchased Services: Program service expenses 0. Management and general expenses 849,789. Fundraising expenses 0. Total expenses 849,789. Form 990, Part XI, line 9: Transfer to parent -139,980. WA Foote Memorial Hospital dba Allegiance Health 205 N East Avenue Jackson MI 49201 382027689 Exempt Hospital MI 501(c)(3) Line 3 Allegiance Health Services 1 Allegiance Health Services 205 N East Avenue Jackson MI 49201 382756428 Exempt Health System MI 501(c)(3) Line 11b, II N/A 0 Allegiance Health Foundation 205 N East Avenue Jackson MI 49201 383607833 Supports Allegiance Health MI 501(c)(3) Line 11b, II Allegiance Health Services 1 Hospice of Jackson dba Allegiance Hospice 205 N East Avenue Jackson MI 49201 382336367 Hospice Care MI 501(c)(3) Line 7 Heathlink 1 The Hospice of Jackson Endowment Fund One Jackson Square Jackson MI 49201 383422146 Raise Funds for Allegiance Hospice MI 501(c)(3) Line 11b, II Allegiance Hospice 1 Healthlink 205 N East Avenue Jackson MI 49201 382756425 Home Health Care MI 501(c)(3) Line 11a, I Allegiance Health Services 1 Allegiance Health Volunteers 205 N East Avenue Jackson MI 49201 386082835 Exempt Association MI 501(c)(3) Line 7 Allegiance Health Services 1 Foote Health Center Associates 1100 E Michigan Avenue Jackson MI 49201 383017711 Lessor of Medical Condominiums MI WA Foote Memorial Hospital Related 0 0 0.54430 Viking Health System Inc 205 N East Avenue Jackson MI 49201 382756161 Idle Healthcare Administration Corporation MI WA Foote Memorial Hospital C 1.00000 0 Cascades Insurance Company LTD 205 N East Avenue Jackson MI 49201 981132982 Hospital Malpractice Insurance Captive CJ WA Foote Memorial Hospital C 1.00000 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 1 0 WA Foote Memorial Hospital L 1268856 FMV WA Foote Memorial Hospital M 5834000 FMV WA Foote Memorial Hospital A 49260 FMV Allegiance Health Services R 139980