COREWELL HEALTH: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-2748035)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-15
- IRS object ID
- 201642289349303529
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-15T11:38:26-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | 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 | 511 RENAISSANCE DR STE 120 | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382748035 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 2699836501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4368 CLEVELAND AVENUE | AddressLine1Txt |
| City | STEVENSVILLE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49127 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY CALHOUN | PersonNm |
| Person Title | VP - FINANCE & CFO | PersonTitleTxt |
| Phone | 2699836501 | PhoneNum |
| Signature | 2016-08-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KENLEY PENNER CPA | PreparerPersonNm |
| PTIN | P00740260 | PTIN |
| Phone | 2699828000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PINE RIDGE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LOREN HAMEL MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVENUE | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,326,005 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | LAKELANDHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN THE SOUTHWEST MICHIGAN AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 155 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $400,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,016,292 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,262,005 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21 | PYInvestmentIncomeAmt |
| CY Investment Income | -$98,908 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $8,416,313 | PYTotalRevenueAmt |
| CY Total Revenue | $10,163,097 | 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 | $5,040,239 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,769,423 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,449,913 | PYOtherExpensesAmt |
| CY Other Expenses | $4,261,846 | CYOtherExpensesAmt |
| PY Total Expenses | $8,490,152 | PYTotalExpensesAmt |
| CY Total Expenses | $10,031,269 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$73,839 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $131,828 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,249,493 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,182,814 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,398,180 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,199,673 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,851,313 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,983,141 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ENHANCE HEALTH AND SERVE OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,639,131 | ExpenseAmt |
| Revenue | $10,262,005 | RevenueAmt |
| Desc | REHABILITATION & NURSING HOME OPERATIONS WERE PROVIDED TO 386 PATIENTS. | Desc |
| Total Program Service Expenses | $8,639,131 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| 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 | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 155 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAUL KONOPACKI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2694282416 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3776 HOLLYWOOD RD | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 |
|---|---|---|---|---|---|---|---|
| MICHAEL MORTIMORE | |||||||
| CHAIRMAN | 1.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KAY VARGA-SMITH | |||||||
| VICE CHAIRMAN | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LYNN KELLOGG | |||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAVE VILLAGE | |||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LOREN HAMEL MD | |||||||
| PRESIDENT & CEO | 3.00 | 52.00 | Yes (X) | Yes (X) | $0 | $820,557 | $17,922 |
| LAURENCE HABENICHT MD | |||||||
| DIRECTOR | 1.00 | 41.00 | Yes (X) | $0 | $315,526 | $96,868 | |
| EWANAH JOHNSON MD | |||||||
| DIRECTOR | 1.00 | 41.00 | Yes (X) | $0 | $330,583 | $27,130 | |
| JEROME WILBURN MD | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DANIEL HOPP | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY JO PARKER | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TIMOTHY CALHOUN | |||||||
| VP - FINANCE & CFO | 3.00 | 47.00 | Yes (X) | $0 | $416,079 | $20,213 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,882,745 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $162,133 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REHABCARE GROUP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 503534 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 631503534 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | THERAPY SERVICES | ServicesDesc |
| Compensation | $766,730 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE (90% MEDI | 621400 | $10,244,919 | $10,244,919 |
| OTHER OPERATING REVENUE | 621400 | $17,086 | $17,086 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,262,005 | TotalProgramServiceRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $64,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $162,908 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$98,908 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$98,908 | TotalRevenueColumnAmt |
| Exclusion | -$98,908 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,163,097 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,262,005 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$98,908 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,662,281 | TotalAmt |
| Program Services | $3,962,939 | ProgramServicesAmt |
| Management And General | $699,342 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $813,995 | TotalAmt |
| Program Services | $691,896 | ProgramServicesAmt |
| Management And General | $122,099 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,147 | TotalAmt |
| Program Services | $249,175 | ProgramServicesAmt |
| Management And General | $43,972 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100 | TotalAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,575 | TotalAmt |
| Management And General | $4,575 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,116,375 | TotalAmt |
| Program Services | $948,919 | ProgramServicesAmt |
| Management And General | $167,456 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,396 | TotalAmt |
| Program Services | $19,037 | ProgramServicesAmt |
| Management And General | $3,359 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,975 | TotalAmt |
| Program Services | $127,479 | ProgramServicesAmt |
| Management And General | $22,496 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,362 | TotalAmt |
| Program Services | $2,008 | ProgramServicesAmt |
| Management And General | $354 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,650 | TotalAmt |
| Program Services | $207,103 | ProgramServicesAmt |
| Management And General | $36,547 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480,976 | TotalAmt |
| Program Services | $408,830 | ProgramServicesAmt |
| Management And General | $72,146 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,247 | TotalAmt |
| Program Services | $9,560 | ProgramServicesAmt |
| Management And General | $1,687 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES AND DRUGS | $1,132,251 | $962,413 | $169,838 |
| QAAP ASSESSMENTS | $667,532 | $667,532 | |
| MISCELLANEOUS | $147,135 | $125,063 | $22,072 |
| PROVISION FOR BAD DEBTS | $109,314 | $109,314 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,958 | TotalAmt |
| Program Services | $147,863 | ProgramServicesAmt |
| Management And General | $26,095 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,031,269 | TotalAmt |
| Program Services | $8,639,131 | ProgramServicesAmt |
| Management And General | $1,392,138 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $833,015 | BOYAmt |
| EOY | $615,084 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $849,153 | BOYAmt |
| EOY | $1,327,467 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,975 | BOYAmt |
| EOY | $8,889 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,859,869 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $770,483 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,677,532 | BOYAmt |
| EOY | $10,089,386 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $886,818 | BOYAmt |
| EOY | $141,988 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,249,493 | BOYAmt |
| EOY | $12,182,814 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $563,588 | BOYAmt |
| EOY | $888,076 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,760,325 | BOYAmt |
| EOY | $8,125,694 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,267 | BOYAmt |
| EOY | $185,903 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,398,180 | BOYAmt |
| EOY | $9,199,673 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,851,313 | BOYAmt |
| EOY | $2,983,141 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,851,313 | BOYAmt |
| EOY | $2,983,141 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,249,493 | BOYAmt |
| EOY | $12,182,814 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $131,828 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $60 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $400,000 | CurrentTaxYearMinus1YearAmt |
| Total | $400,060 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,028,555 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,410,997 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,271,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,016,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,262,005 | CurrentTaxYearAmt |
| Total | $40,989,738 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,028,615 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,410,997 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,271,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,416,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,262,005 | CurrentTaxYearAmt |
| Total | $41,389,798 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $41,389,798 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $787 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,769 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $357 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21 | CurrentTaxYearMinus1YearAmt |
| Total | $5,934 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $787 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,769 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $357 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21 | CurrentTaxYearMinus1YearAmt |
| Total | $5,934 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,029,402 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,415,766 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,272,246 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,416,313 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,262,005 | CurrentTaxYearAmt |
| Total | $41,395,732 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99990 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99980 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $610,891 | OtherCostOrOtherBasisAmt |
| Book Value | $610,891 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,358,317 | OtherCostOrOtherBasisAmt |
| Depreciation | $345,861 | DepreciationAmt |
| Book Value | $8,012,456 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,890,661 | OtherCostOrOtherBasisAmt |
| Depreciation | $424,622 | DepreciationAmt |
| Book Value | $1,466,039 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,089,386 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED PARTIES | Desc |
| Amt | $185,903 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $185,903 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,053,783 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$109,314 | OtherRevenueAmt |
| Revenue Not Reported | -$109,314 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,163,097 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,163,097 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,921,955 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,921,955 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $109,314 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $109,314 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,031,269 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | LAKELAND REGIONAL HEALTH SYSTEM, INC. AND ITS WHOLLY OWNED SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES EXCEPT FOR LAKELAND HEALTH ENTERPRISES, INC. AND SUBSIDIARIES, WHICH ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. INCOME TAX EXPENSE FOR THE FOR-PROFIT CORPORATIONS IS NOT SIGNIFICANT AND HAS BEEN INCLUDED IN OPERATING EXPENSES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY LAKELAND AND RECOGNIZE A TAX LIABILITY IF LAKELAND 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 LAKELAND AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. LAKELAND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS -109,314. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 109,314. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOREN HAMEL MD | ||||||||||||||
| PRESIDENT & CEO | $0 | $586,116 | $0 | $168,449 | $0 | $65,992 | $0 | $15,450 | $0 | $2,472 | $0 | $838,479 | $0 | $0 |
| LAURENCE HABENICHT MD | ||||||||||||||
| DIRECTOR | $0 | $315,526 | $0 | $0 | $0 | $0 | $0 | $93,885 | $0 | $2,983 | $0 | $412,394 | $0 | $0 |
| EWANAH JOHNSON MD | ||||||||||||||
| DIRECTOR | $0 | $330,583 | $0 | $0 | $0 | $0 | $0 | $17,500 | $0 | $9,630 | $0 | $357,713 | $0 | $0 |
| TIMOTHY CALHOUN | ||||||||||||||
| VP - FINANCE & CFO | $0 | $333,440 | $0 | $57,986 | $0 | $24,653 | $0 | $15,450 | $0 | $4,763 | $0 | $436,292 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | LAKELAND MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE PLAN ARE: LOREN HAMEL, MD; TIMOTHY CALHOUN; EILEEN WILLITS | 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 | HOSPITAL AUTHORITY OF THE CITY OF ST JOSEPH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 383151499 | BondIssuerEIN |
| CUSIP | NONEAVIAL | CUSIPNum |
| Bond Issued | 2012-09-06 | BondIssuedDt |
| Issue Price | $8,500,000 | IssuePriceAmt |
| Purpose | NEW FACILITY CONSTRUCTION | 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 |
| Total Proceeds | $8,500,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $105,875 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $8,394,125 | CapitalExpendituresAmt |
| Current Refunding | 0 | 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 | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | BOND ISSUE A: | FormAndLineReferenceDesc |
| Explanation | THE $8.5 MILLION BOND ISSUE WAS A DIRECT PURCHASE BOND BY JPMORGAN CHASE. BOND PROCEEDS WERE DRAWN DURING CONSTRUCTION PERIOD TO BUILD A NEW FACILITY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, ITEM C | DBA: LAKELAND CONTINUING CARE CENTER |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE 990 HAS BEEN POSTED ON THE BOARD PORTAL FOR REVIEW PRIOR TO FILING. THE BOARD PORTAL IS AVAILABLE TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEO'S COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | THERAPY SERVICES: PROGRAM SERVICE EXPENSES 784,111. MANAGEMENT AND GENERAL EXPENSES 138,372. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 922,483. MAITENANCE AND OTHER ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 164,808. MANAGEMENT AND GENERAL EXPENSES 29,084. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 193,892. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN THE AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKELAND REGIONAL HEALTH SYSTEM INC | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382609624 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(C)(3) | LINE 11B, II | N/A | 0 | |
| LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382156872 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(C)(3) | LINE 3 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND SPECIALITY HOSPITAL AT BERRIEN CENTER | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383452303 | LONGTERM HEALTHCARE/HEALING SERVICES | MI | 501(C)(3) | LINE 3 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382539929 | PROMOTE AND ASSIST IN PROVIDING HEALTH CARE | MI | 501(C)(3) | LINE 7 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND HEALTH FOUNDATION NILES | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383130558 | PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGAN | MI | 501(C)(3) | LINE 7 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND COMMUNITY HOSPITAL - WATERVLIET | |||||||||||
| 400 MEDICAL PARK DRIVE | WATERVLIET | MI | 49098 | 381368745 | TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCARE | MI | 501(C)(3) | LINE 9 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| HOSPICE AT HOME INC | |||||||||||
| 4025 HEALTH PARK LANE | ST JOSEPH | MI | 49085 | 382416086 | TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILL | MI | 501(C)(3) | LINE 7 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| VAN'S MEDICAL EQUIPMENT OF LAKELAND LLC | |||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 261497708 | MEDICAL EQUIPMENT | MI | N/A |
| CLIFFSIDE COMPANY LLC | |||||||
| 910 S WASHINGTON AVENUE | ROYAL OAK | MI | 48067 | 383306320 | ASSISTED LIVING | MI | N/A |
| LAKELINE ASSOCIATES LLC | |||||||
| 910 S WASHINGTON AVENUE | ROYAL OAK | MI | 48067 | 383306318 | PROPERTY MANAGEMENT/RENTAL | MI | N/A |
| LIBERTY DIALYSIS LAKELAND LLC | |||||||
| 7650 SE 27TH STREET SUITE 200 | MERCER ISLAND | WA | 98040 | 272099855 | MEDICAL SERVICES | WA | N/A |
| LDBH LLC | |||||||
| 7650 SE 27TH STREET SUITE 200 | MERCER ISLAND | WA | 98040 | 451745643 | MEDICAL SERVICES | WA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| LAKELAND HEALTH ENTERPRISES INC | |||||||||
| 31 NORTH ST JOSEPH AVENUE | NILES | MI | 49120 | 382669798 | ACCOUNTING AND BILLING | MI | N/A | C | Yes (1) |
| PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382929090 | PHARMACEUTICALS | MI | N/A | C | Yes (1) |
| LAKELAND MEDICAL PRACTICES | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 270381199 | MEDICAL ADMINISTRATIVE SERVICES | MI | N/A | C | Yes (1) |
| SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272589359 | PHYSICIAN OFFICE | MI | N/A | C | Yes (1) |
| FOUR FLAGS PROPERTIES INC | |||||||||
| 122 GRANT STREET | NILES | MI | 49120 | 364501639 | PROPERTY MANAGEMENT/RENTAL | MI | N/A | C | Yes (1) |
| LAKELAND HEALTH VENTURES INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272313790 | HOLDING COMPANY | MI | N/A | C | Yes (1) |
| LAKELAND PHYSICIAN CARE NETWORK | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 208513031 | MEDICAL SERVICES | MI | N/A | C | Yes (1) |
| LAKELAND PERSONAL CARE SERVICES INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272990797 | HEALTH CARE SERVICES | MI | N/A | C | Yes (1) |
| LAKELAND CARE INC | |||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383225306 | CONTRACT NEGOTIATION | MI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND HOSPITALS AT NILES AND ST JOSEPH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | $415,969 | InvolvedAmt |
| Method Of Amount Determination | ALLOCATION OF EXPENSES | MethodOfAmountDeterminationTxt |
Comments