2016-02-12T08:09:00-06:00 2015-03-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2014-04-01 208756459 MACKINAC STRAITS HEALTH SYSTEM INC MACK 9066438585 1140 N STATE STREET ST IGNACE MI 49781 JASON ANDERSON CFO 9066438585 2016-02-08 1 TERRI REXRODE CPA MST P00096513 9206620016 2016-02-08 2014 2016-08-17 19:52:53Z JASON ANDERSON 1140 N STATE STREET ST IGNACE MI 49781 34976800 0 X MACKINACSTRAITSHEALTH.ORG X 2008 MI WE WILL BE THE HOSPITAL OF CHOICE AND RECOGNIZED FOR OUR EXEMPLARY PATIENT CARE, PEOPLE AND PERFORMANCE. WE HAVE A PASSION FOR EXCELLENCE AND STRIVE TO SET AND DELIVER THE HIGHEST STANDARDS OF SERVICE, INTEGRITY AND MOST OF ALL QUALITY. WE VALUE THE DIVERSITY AND CULTURES IN OUR COMMUNITY. 10 7 330 15 0 0 337133 84624 29732071 33552611 56339 15595 1310469 1310964 31436012 34963794 0 0 0 0 17221739 17507033 0 0 0 19135147 24920073 36356886 42427106 -4920874 -7463312 47557933 50127033 59282825 69856953 -11724892 -19729920 PROVIDING LOCAL ACCESS AND QUALITY HEALTHCARE TO THE FAMILIES AND COMMUNITIES WE SERVE. 0 0 35858239 34633639 MACKINAC STRAITS HEALTH SYSTEM, INC. OPERATES A 15-BED ACUTE CARE FACILITY, A 48-BED LONG-TERM CARE UNIT, AND SEVERAL PHYSICIAN CLINICS IN MACKINAC COUNTY, MICHIGAN. THE PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, AND PHYSICIAN SERVICES TO THE RESIDENTS OF MACKINAC COUNTY AND THE SURROUNDING AREAS. 35858239 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 25 0 330 1 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JASON ANDERSON 9066438585 1140 N STATE STREET ST IGNACE MI 49781 JAMES NORTH BOARD TREASURER 1.00 X X 0 0 0 PRENTISS BROWN BOARD MEMBER 1.00 X 0 0 0 CHRISTINE MCPHERSON BOARD MEMBER 1.00 X 0 0 0 DR CARL HAWKINS BOARD MEMBER/CHIEF OF STAF 40.00 X 159858 0 19096 PATRICK SHANNON BOARD CHAIRMAN 1.00 X X 0 0 0 STEVE AUTORE BOARD SECRETARY 1.00 X X 0 0 0 MARGARET DOUD BOARD MEMBER 1.00 X 0 0 0 DR EDWARD SMITH PHYSICIAN 40.00 X 396898 0 21034 DR MATTHEW BOWES BOARD MEMBER/PHYSICIAN 40.00 X 448390 0 19015 MARY MAURER BOARD VICE CHAIR 1.00 X X 0 0 0 RODNEY NELSON CEO 40.00 2.00 X 143433 0 18296 JASON ANDERSON CFO 40.00 2.00 X 104771 0 18296 DR SUSAN HEPKER PHYSICIAN 40.00 X 421041 0 18296 DR RODERICK BALTZER PHYSICIAN 40.00 X 259615 0 6690 DR ALIC LINDSEY PHYSICIAN 40.00 X 176739 0 6098 2110745 0 126821 8 0 1 0 RALPH OLECHOWSKI 1140 N STATE ST ST IGNACE MI 49781 PHYSICIAN SERVICES 185070 DONZA WORDEN 1140 N STATE ST ST IGNACE MI 49781 PHYSICIAN SERVICES 125961 RICHARD HODGEMAN 1140 N STATE ST ST IGNACE MI 49781 PHYSICIAN SERVICES 115675 3 43866 40758 84624 PATIENT REVENUE 900099 32488829 32488829 QAAP REVENUE 900099 1001282 1001282 AFFILIATE RENTAL REVENUE 900099 62500 62500 33552611 28601 28601 13006 -13006 -13006 -13006 TAX LEVY 900099 1143528 1143528 PHYSICIAN INCENTIVES 900099 167436 167436 1310964 34963794 34633639 0 245531 X 1349087 1064291 284796 11373964 10660602 713362 954656 881959 72697 2935035 2740835 194200 894291 826191 68100 292780 284580 8200 140287 140287 4600159 4301446 298713 72834 72834 4276368 4273352 3016 4030004 3972172 57832 88720 76865 11855 32954 29644 3310 2336860 2336860 1991376 1991376 169657 169657 LOSS ON REFINANCING 4220744 4220744 BAD DEBT EXPENSE 1624634 1624634 QAAP TAXES PAID 620186 620186 MINOR EQUIPMENT 142209 142209 0 280301 268445 11856 42427106 35858239 6568867 0 1964 1997116 291456 78903 82971 4069010 4898078 36392 22297 201122 500000 523422 933098 37671 57483 52038995 10775394 38139951 41263601 4173974 376457 47557933 50127033 5485764 4690114 40000 2209406 220000 42990761 54838489 10546300 8118944 59282825 69856953 X -11753267 -19758675 28375 28755 -11724892 -19729920 47557933 50127033 X -7463312 -541716 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 2793 2793 0 PART II-B, LINE 1: THE ORGANIZATION BELONGS TO THE AHA AND MHA AND PAYS DUES. A PORTION OF THE DUES ARE SPENT ON LOBBYING ACTIVITIES. 1200000 1200000 37745406 7559558 30185848 3193628 697512 2496116 9865295 2518324 7346971 34666 34666 41263601 AMOUNTS PAYABLE TO THIRD PARTIES 1809338 PENSION LIABILITY 5767465 PATIENT TRUST SAVINGS 23651 LINE OF CREDIT 494378 CAPITAL LEASE OBLIGATION 24112 8118944 34251984 -711810 -711810 34963794 0 34963794 40182286 0 40182286 2244820 2244820 42427106 PART XI, LINE 2D - OTHER ADJUSTMENTS: QAAP PAYMENTS -620,186. BAD DEBT EXPENSE -1,624,634. FDN REVENUE 1,533,010. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 1,624,634. QAAP PAYMENTS 620,186. 1 1 1 X 1 X 150.000000000000 1 0 1 1 312704 312704 0.00770 2638529 2276548 361981 0.00890 2951233 2276548 674685 0.01660 14824 14824 0.00040 83631 83631 0.00200 560935 258782 302153 0.00740 35792 35792 0.00090 695182 258782 436400 0.01070 3646415 2535330 1111085 0.02730 0 1331029 10532291 10742754 -210463 X 1 0 1 1 MACKINAC STRAITS HEALTH SYSTEM INC 1140 N STATE STREET ST IGNACE MI 49781 WWW.MACKINACSTRAITSHEALTH.ORG MW0043832 X X X RHC MACKINAC STRAITS HEALTH SYSTEM INC 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X HTTP://MACKINACSTRAITSHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTML X 1 13 1 HTTP://MACKINACSTRAITSHEALTH.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENT.HTML 1 0 1 X 100.000000000000 150.000000000000 X X X 1 1 1 X 1 X X 1 X X X 1 X 0 0 MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 5: KEY INFORMATIONAL INTERVIEWS WERE CONDUCTED WITH MEMBERS OF THE COMMUNITY SERVED BY MACKINAC STRAITS HEALTH SYSTEM. THESE INDIVIDUALS WERE IDENTIFIED BY THE COMMITTEE BASED ON THEIR QUALIFICATIONS TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED. GENERALLY, THE INTERVIEWEES INCLUDED PERSOMS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND PERSONS WHO REPRESENT THE MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. MACKINAC STRAITS HEALTH SYSTEM, INC. PART V, SECTION B, LINE 22D: FAP ELIGIBLE PATIENTS RECEIVE A DISCOUNT WHICH IS A SLIDING FEE BASED ON POVERTY LEVEL. 5 PICKFORD MEDICAL CENTER 7742 N M-129 PICKFORD MI 49774 PHYSICIAN OFFICE NAUBINWAY FAMILY HEALTH CLINIC 11650 W HWY US-2 NAUBINWAY MI 49762 PHYSICIAN OFFICE MACKINAW CITY MEDICAL CLINIC 580 SOUTH NICOLET ST MACKINAW CITY MI 49701 PHYSICIAN OFFICE MACKINAC ISLAND MEDICAL CLINIC 7474 MARKET STREET MACKINAC ISLAND MI 49757 EMERGENCY ROOM RIVERTOWN MEDICAL CENTER 920 SOUTH HURON STREET CHEBOYGAN MI 49721 PHYSICIAN OFFICE PART I, LINE 7: THE ORGANIZATION UTILIZES A COST TO CHARGE RATIO WHEN CALCULATING THE PERCENTAGE OF CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE IS CALCULATED UTILIZING ACTUAL WRITE-OFFS AND THE AMOUNTS THAT HAVE BEEN DETERMINED LIKELY TO BE WRITTEN OFF GIVEN PAST EXPERIENCE OF THE COLLECTION POSSIBILITIES. ALTHOUGH THERE ARE SOME AMOUNTS OF CHARITY CARE INCLUDED IN THIS AMOUNT, THERE IS NOT A CURRENT METHOD TO EASILY OBTAIN THE AMOUNT THAT SHOULD HAVE BEEN CHARITY CARE. PART II, COMMUNITY BUILDING ACTIVITIES: PROVIDED 24 HOUR EMERGENCY AND ESSENTIAL HEALTH CARE SERVICES TO RURAL COMMUNITY. PART III, LINE 4: THERE IS NOT ANY FIANANCIAL STATEMENT FOOTNOTE ON BAD DEBT EXPENSE. PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE FROM THE MEDICARE COST REPORT PART VI, LINE 2: FEEDBACK FROM COMMUNITY MEMBERS VIA SURVEY AND PRESENTATIONS AT LOCAL ORGANIZATIONS PART VI, LINE 3: PAMPLETS AND OTHER LITERATURE AND SIGNAGE PART VI, LINE 4: MACKINAC COUNTY - A RURAL COUNTY IN MICHIGAN'S UPPER PENNINSULA. SEASONAL ECONOMY WITH HIGHER THAN AVERAGE UNEMPLOYMENT. AGING POPULATION WITH LARGE NUMBER OF NATIVE AMERICANS. PART VI, LINE 5: A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND ALSO PROVIDES COURTESY PRIVILIGES TO AMNY VISITING SPECIALISTS WHO ARE ALSO PROVIDED SPACE IN OUR BUILDINGS IN ORDER TO SEE THEIR PATIENTS. X X X X 0 0 0 0 0 0 0 0 0 DR CARL HAWKINS BOARD MEMBER/CHIEF OF STAF 159343 0 0 0 515 0 0 0 19096 0 178954 0 0 0 DR EDWARD SMITH PHYSICIAN 395773 0 0 0 1125 0 738 0 20296 0 417932 0 0 0 DR MATTHEW BOWES BOARD MEMBER/PHYSICIAN 448390 0 0 0 0 0 719 0 18296 0 467405 0 0 0 RODNEY NELSON CEO 142980 0 0 0 453 0 0 0 18296 0 161729 0 0 0 DR SUSAN HEPKER PHYSICIAN 412485 0 0 0 8556 0 0 0 18296 0 439337 0 0 0 DR RODERICK BALTZER PHYSICIAN 248767 0 0 0 10848 0 592 0 6098 0 266305 0 0 0 DR ALIC LINDSEY PHYSICIAN 176739 0 0 0 0 0 0 0 6098 0 182837 0 0 0 DR SUSAN HEPKER PHYSICIAN/FORMER BOARD MEMBER RELOCATION/HOUSING X 90000 22297 0 1 1 22297 FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS HAS DELEGATED TO REVIEW AND APPROVAL OF THE FORM 990 TO THE CFO. THE 990 RETURN IS E-MAILED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS MONITORS THE CONFLICT OF INTEREST POLICY. NEW CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD IN ACCORDANCE WITH THE POLICY AND DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. THE COMPENSATION IS THEN REVIEWED BY THE BOARD FOR THE CEO AND IS REVIEWED BY THE CEO FOR OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THEIR DOCUMENTATION AVAILABLE TO THE PUBLIC BY REQUEST ONLY. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 MAKING THEM AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,480,066. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,480,066. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 601,484. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 601,484. NURSING SERVICES: PROGRAM SERVICE EXPENSES 232,071. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 232,071. SURGERY SERVICES: PROGRAM SERVICE EXPENSES 243,378. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 243,378. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 229,240. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 229,240. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 95,241. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 95,241. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 178,139. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 178,139. DIALYSIS SERVICES: PROGRAM SERVICE EXPENSES 20,704. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,704. CLINIC SERVICES: PROGRAM SERVICE EXPENSES 231,764. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 231,764. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 123,304. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 123,304. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 116,160. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 116,160. INFORMATION TECHNOLOGY SERVICES: PROGRAM SERVICE EXPENSES 621,868. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 621,868. RISK MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 25,879. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,879. MATERIALS MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 26,533. MANAGEMENT AND GENERAL EXPENSES 4,653. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,186. MISCELLANEOUS SERVICES: PROGRAM SERVICE EXPENSES 3,546. MANAGEMENT AND GENERAL EXPENSES 7,840. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,386. ONCOLOGY SERVICES: PROGRAM SERVICE EXPENSES 47,983. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,983. FISCAL & ADMINISTRATION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 223,098. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 223,098. HUMAN RESOURCES SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 54,298. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,298. EDCUATION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,824. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,824. MEDICAL RECORDS SERVICES: PROGRAM SERVICE EXPENSES 24,086. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,086. FORM 990, PART XI, LINE 9: CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -345,884. RECONCILING ITEM FROM PRIOR YEAR (RESTRICTED CONTRIBUTION ADJUSTMENT) -195,832. FORM 990, PART XI, LINE 2C THE AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE MACKINAC STRAITS HEALTH SYSTEM FINANCE COMMITTEE AND RECOMMENDATIONS ARE TAKEN TO THE MACKINAC STRAITS HEALTH SYSTEM BOARD OF DIRECTORS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSES DIALYSIS UNIT 1140 NORTH STATE STREET ST IGNACE MI 49781 320031170 RENAL DIALYSIS SERVICES MI 501(C)(3) LINE 3 MACKINAC STRAITS HEALTH SYSTEM INC 1 MACKINAC STRAITS AREA HEALTH 1140 NORTH STATE STREET ST IGNACE MI 49781 472021925 SUPPORT MACKINAC STRAITS HEALTH SYSTEM MI 501(C)(3) LINE 11B, II N/A 0 MACKINAC STRAITS HEALTH FOUNDATION 1140 NORTH STATE STREET ST IGNACE MI 49781 465296565 FOUNDATION MI 501(C)(3) LINE 7 MACKINAC STRAITS HEALTH SYSTEM INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0