2015-05-14T09:27:15-05:00 2014-09-30 382477354 BRINING & NARTKER PC 47 AUSTIN STREET PO BOX 348 SANDUSKY MI 484710348 990 2013-10-01 381738615 MCKENZIE MEMORIAL HOSPITAL MCKE 8106486162 120 DELAWARE STREET SANDUSKY MI 48471 AMY RUEDISUELI VP OF FINANCE 8106486162 2015-04-30 true JOSEPH NARTKER P00297844 8106484931 2015-05-14 2013 2016-02-25 16:41:14Z MCKENZIE HEALTH SYSTEM STEVE BARNETT 120 DELEWARE STREET SANDUSKY MI 48471 19045776 false X WWW.MCKENZIEHEALTH.ORG X 1961 MI FOUNDED AS A COMMUNITY HOSPITAL, MCKENIZE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT, COMPASSIONATE AND ESSENTIAL HEALTHCARE. 16 12 254 40 61761 -12076 54535 50352 19312035 18843161 84310 24930 99270 86741 19550150 19005184 0 0 10594857 10631086 0 23447 8441308 8355257 19036165 18986343 513985 18841 9808280 9361826 5361118 4895823 4447162 4466003 FOUNDED AS A COMMUNITY HOSPITAL, MCKENIZE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT, COMPASSIONATE AND ESSENTIAL HEALTHCARE. false false 18986343 19005184 PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SANILAC COUNTY. FISCAL YEAR REGISTRATIONS ARE: INPATIENT = 273 OUTPATIENT = 24,799 EMERGENCY ROOM = 5,630 AMBULANCE = 1,905 18986343 true true false false false false false false false false true false false false true false true false false false false false false false true false true true false false true false false false false false false true false false false false false false true true true false false true 46 0 true 254 true true true false false false false false false false false false false false X 16 12 false false false false true true true true true false false true true true true true true true true true true X X AMY RUEDISUELI 8106486162 394 LORAINE STREET SANDUSKY MI 48471 DR WILLIAM STARBIRD MARLETTE PHY 40.00 X 0 241925 32190 DAN BABCOCK MARLETTE CEO 40.00 X 0 184422 17500 STEVE BARNETT MCKENZIE CEO 40.00 X X 177640 0 21889 MARK ENGLISH CHIEF OF STA 40.00 X 168599 0 25528 ROGER LODING CHAIR PERSON X 0 0 0 CHRIS CLARK VICE CHAIR P X 0 0 0 AL STOUTENBURG SECRETARY X 0 0 0 JUDITH FERGUSON BOARD MEMBER X 0 0 0 LARRY MITCHELL TRUSTEE X 0 0 0 RALPH DESHETSKY TRUSTEE X 0 0 0 MICHAEL DREYER TREASURY X 0 0 0 GLEN KAMPMAN TRUSTEE X 0 0 0 SCOTT ORR X 0 0 0 SUE COOK TRUSTEE X 0 0 0 MEREDITH LYONS TRUSTEE X 0 0 0 JOAN NAGELKIRK TRUSTEE X 0 0 0 AMY RUEDISUELI VP OF FINANC 40.00 X 107406 0 7758 DR ALFREDO DOMINGO PHYSICIAN 40.00 X 282888 0 0 DR JAMES SAMS PHYSICIAN 40.00 X 213688 0 13569 DR MICHAEL MERKLER PHYSICIAN 40.00 X 207067 0 17002 DR MATTHEW GORMLEY PHYSICIAN 40.00 X 195399 0 25129 GINA PATTERSON PHARMACY DIR 32.00 8.00 X 126905 27276 20968 DR MELANIE KRAMER PHYSICIAN X 123751 0 8835 1603343 453623 190368 15 true true false MICHIGAN EMERGENCY PHYSICIANS LLP PO BOX 674579 DETROIT MI 48267 ER COVERAGE 1512751 CPSI 6600 WALL STREET MOBILE AL 36695 COMPUTER TECH 228776 HALL RENDER AND KILLIAN 39778 TREASURY CENTER CHICAGO IL 60694 LEGAL SERVICE 158702 TOSHIBA AMERICAN MEDICAL PO BOX 91605 TUSTIN CA 92780 CT MAINT 124583 COVENANT HEALTHCARE 1447 NORTH HARRISON SAGINAW MI 48602 REFERENCE LAB 115666 7 50352 50352 INPATIENT & OUTPATIENT REVENU 29965337 29965337 PHYSICIAN REVENUE 2760874 2760874 ALL OTHER PROGRAM SERVICE REV 952390 952390 RURAL HEALTH REVENUE 661719 661719 BAD DEBT & CHARITY CARE -856603 -856603 -14640556 -14640556 18843161 24930 24930 61761 61761 61761 61761 61637 40592 21045 21045 SALE OF ASSET 3935 3935 3935 19005184 18872026 61761 21045 X 234102 234102 8413638 6299901 2102507 11230 250881 188280 62601 1066582 757050 309532 665883 500695 164422 766 80530 80530 32871 32871 3198241 2774201 424040 68172 13107 44796 10269 1142084 938678 202524 882 250661 31141 219520 396986 389258 7728 135165 106355 28573 237 30840 15598 15242 26999 24292 2707 767783 593339 174444 166652 153363 13289 IMPLANTABLES & BLOOD 597331 597331 DRUGS 556347 556347 TAXES & LICENSES 415671 48358 367313 FOOD, LAUNDRY, DUES 286092 94414 191615 63 202832 193762 9070 18986343 14275470 4687426 23447 103607 267705 1857145 1720836 2246210 1763585 462844 462932 224235 142224 16026084 11171404 4764375 4854680 149864 149864 9808280 9361826 2561324 2429030 137332 2028420 1918189 634042 548604 5361118 4895823 X 4382077 4392009 65085 73994 4447162 4466003 9808280 9361826 18841 X true true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 160652 160652 7502133 4755923 2746210 264108 206392 57716 8080805 6209089 1871716 18386 18386 4854680 EVERBANK - DIG MAM 132159 ESB - 2 AMBULANCES & TRUCK 103167 KINGSBRIDGE - TELEMETRY 100470 INSIGHT - ULTRASOUND 61231 EMB - ULTRASOUND 48629 TRI COUNTY - AUTOCLAVE & COMPUTERS 45517 NORTHSTAR - AMBULANCE 33085 GE - C - ARM & BONE DENSITY 24346 KINGSBRIDGE - DIGITIZER & CR TRI - COUNTY - AUTOCLAVE ESB - AMBULANCE KINGSBRIDE - STERILIZER ESB - 2013 FORD 548604 18908859 18908859 96325 96325 19005184 18986334 18986334 9 9 18986343 SCHEDULE D, PAGE 4, PART XI, LINE 4B INTEREST INCOME 24,883 CONTRIBUTIONS 62,439 CONTRIBUTIONS RELEASED FROM TEMP. RESTRICTED NET ASSETS 8,958 INTEREST FROM TEMPORARY RESTRICITIONS 48 ROUNDING -3 SCHEDULE D, PAGE 4, PART XII, LINE 4B ROUNDING 9 MI BENEFIT RAFFLE 33867 33867 4500 4599 450 1364 HOSP AUXILARY 27770 27770 29679 61637 61637 4500 4599 450 31043 40592 21045 true true true X true X false true false false 1 33 64130 64130 0.00340 1 3436788 2317096 1119692 0.05900 2 33 3500918 2317096 1183822 0.06240 366 3592 72209 42491 29718 0.00160 1 11473 11473 0.00060 1 6587 6587 0.00030 3 152 1664 530 1134 0.00010 371 3744 91933 43021 48912 0.00260 373 3777 3592851 2360117 1232734 0.06500 10 794 3728 150 3578 0.00020 9 228 228 19 794 3956 150 3806 0.00020 true 475884 45564 6158569 6257349 -98780 X true true 1 1 MCKENZIE MEMORIAL HOSPITAL DBA MCKENZIE HEALTH SYSTEM 120 DELAWARE STREET SANDUSKY MI 48471 WWW.MCKENZIEHEALTH.ORG L414719 X MCKENZIE MEMORIAL HOSPITAL 1 true X X X X X X X X 12 true false true X X X X false false true true 100.000000000000 true 250.000000000000 true X X X X true true X X X X X true false X X X X true X false false FACILITY 1, MCKENZIE MEMORIAL HOSPITAL - PART V, LINE 3 MCKENZIE MEMORIAL HOSPITAL PARTICIPATED IN A COMMUNITY MANAGERS COMMITTEE WHICH CONSISTS OF MEMBERS FROM THE FOLLOWING ORGANIZATIONS: SANILAC COUNTY, SANILAC COUNTY MEDICAL FACILITY, SANILAC COUNTY INTERMEDIATE SCHOOL DISTRICT, SANDUSKY COMMUNITY SCHOOLS, SANILAC COUNTY COMMUNITY MENTAL HEALTH, CITY OF SANDUSKY, SANILAC COUNTY HEALTH DEPARTMENT AND THE SANILAC ROAD COMMISSION. INPUT FROM THESE ORGANIZATIONS REGARDING THE HEALTH OF OUR COMMUNITY AND ITS NEEDS IS CONSIDERED. IN ADDITION, MCKENZIE HELD TWO PUBLIC MEETINGS IN APRIL 2013 WHERE WE INVITED OVER 1000 PARTICIPANTS TO COME AND SHARE THEIR CONCERNS ABOUT THE HEALTH OF THE COMMUNITY. PARTICIPATING COMMUNITY EMPLOYERS INCLUDED THE SANILAC COUNTY COURT HOUSE, SANDUSKY SCHOOLS, TELLEBORG, INC., JENSEN BRIDGE, INC. AND THE SANILAC MEDICAL CARE FACILTY. FACILITY 1, MCKENZIE MEMORIAL HOSPITAL - PART V, LINE 7 MCKENZIE MEMORIAL HOSPITAL WAS NOT ABLE TO ADDRESS ALL THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA. IT WAS IDENTIFIED THAT AN EAR, NOSE, AND THROAT (ENT) SPECIALIST IS NEEDED IN SANDUSKY. IT IS VERY DIFFICULT TO RECRUIT SPECIALISTS TO OUR SMALL RURAL TOWN BECAUSE OF THE LACK OF VOLUME TO SUSTAIN THIS TYPE OF SPECIALIST. HOWEVER, WE ARE WORKING TO BRING SPECIALIST TO OUR HOSPITAL VIA TELEMEDICINE. THE SECOND ITEM THAT WE WERE UNABLE TO SOLVE IS LONGER PHYSICIAN OFFICE HOURS AND WEEKEND HOURS. WE ARE CURRENTLY EVALUATING THE FINANCIAL VIABILITY OF AN URGENT CARE CLINIC. THE PRIMARY HURDLE IN OPERATING A LOCAL URGENT CARE CLINIC IS THE AVAILABILITY OF HEALTH CARE PROVIDERS TO STAFF THE CLINIC. 8 MCKENZIE HEALTH AND WELLNESS 170 W ARGYLE STREET SANDUSKY MI 48471 PHYSICIAN OFFICE/PT OFFICE AUSTIN STREET RURAL HEALTH CLINIC 51 AUSTIN STREET SANDUSKY MI 48471 RURAL HEALTH CLINIC MAIN STREET HEALTH CENTER 74 S ELK ST SANDUSKY MI 48471 PHYSICIAN ORTHOPEDIC OFFICE MCKENZIE FAMILY HEALTHCARE 109 N DELAWARE STREET SANDUSKY MI 48471 PHYSICIAN OFFICE LAKESHORE INTERNAL MEDICINE 7307 CHERRY STREET PORT SANILAC MI 48469 PHYSICIAN OFFICE CROSWEL CLINIC 8 N HOWARD STREET CROSWELL MI 48422 PHSICIAN OFFICE PECK MEDICAL CENTER 251 E PECK RD PECK MI 48466 PHYSICIAN OFFICE SANILAC MEDICAL PLAZA 100 W ARGYLE STREET SANDUSKY MI 48471 PHYSICIAN OFFICE RENTAL PART I, LINE 6A - RELATED ORGANIZATION INFORMATION A COMMUNITY BENEFIT REPORT WAS PREPARED DURING A PREVIOUS TAX YEAR; IN JUNE 2013. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION MCKENZIE USES SCHEDULE H WORKSHEETS TO PREPARE THE INFORMATION IN BOX 7, USING OUR COST TO CHARGE RATIO. PART II - COMMUNITY BUILDING ACTIVITIES MCKENZIE'S COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY BY SUPPORTING THE LOCAL COMMUNITY THROUGH VARIOUS ACTIVITIES. EXAMPLES OF THESE ACTIVITES ARE THE COMMUNITY SENIOR FAIR, SCHOOL TOURS, SANILAC 4-H FAIR AND OTHER VARIOUS SHOWCASES. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY BAD DEBTS ARE ESTIMATED USING THE ALLOWANCE METHOD. THE BAD DEBT EXPENSE LISTED ON LINE 2 IS DETERMINED USING COST BASED UPON THE COST TO CHARGE RATIO THAT IS DEVELOPED IN SCHEDULE H. PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE COST OF BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. ANALYZED FINANCIAL ASSISTANCE/CHARITY CARE APPLICATIONS THAT WERE DENIED DUE TO INCOMPLETE DOCUMENTATION AND FAILURE TO PROVIDE REQUESTED INFORMATION AND APPLIED COST TO CHARGE RATIO AS DETERMINED IN SCHEDULE H. THIS EXPENSE IS INCLUDED AS IT IS OUR COMMUNITY THAT CANNOT AFFORD TO PAY THEIR HEALTHCARE EXPENSES. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS BAD DEBT FOOTNOTE IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS ON PAGE 10, NOTE 1, PARAGRAPH 3. PART III, LINE 8 - MEDICARE EXPLANATION THE HOSPITAL IS DESIGNATED A CRITICAL ACCESS HOSPITAL UNDER MEDICARE REGULATIONS. ALTHOUGH MOST SERVICES OF CRITICAL ACCESS HOSITALS ARE COST REIMBURSED, THERE ARE CERTIAN SERVICES THAT ARE PROVIDED THAT DO NOT FALL UNDER THE REIMBURSEMENT METHODOLOGY. THE SHORTFALL OF 98,780 DERIVES FORM THOSE NECESSARY SERVICES THAT ARE PROVIDED THAT ARE NOT COST BASED REIMBURSED. COST REPORT DATA OR THE APPLICABLE COST TO CHARGE RATIO WAS USED TO COMPUTE THESE FIGURES. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION MCKENZIE'S COLLECTION POLICY REFERENCES THE CHARITY CARE/FINANCIAL ASSISTANCE POLICY FOR THOSE PATIENTS THAT ARE ELIGIBLE FOR CHARITY CARE/FINANCIAL ASSISTANCE AS A METHOD OF PAYMENT/COLLECTIONS. PART VI, LINE 2 - NEEDS ASSESSMENT THE PURPOSE OF THE 2013 MCKENZIE MEMORIAL HOSPITAL COMMUNITY NEEDS ASSESMENT WAS TO COLLECT DATA ON SPECIFIC INFORMATION REGARDING COMMUNITY PERCEPTION OF THE USE OF HEALTHCARE SERVICES, COMMUNITY HEALTH AND HEALTH INSURANCE. A COMPREHENSIVE NINE PAGE SURVEY WAS DEVELOPED. A COVER LETTER AND SURVEY WERE SENT TO 1,000 RANDOM COMMUNITY MEMBERS IN THE MCKENZIE SERVICE AREAS. THE COMPANY ACCULEADS, PROVIDED RANDOMIZED MAILING ADDRESSES FOR THE CITIES OF APPLEGATE, CARSONVILLE, DECKERVILLE, LEXINGTON, MARLETTE, PECK, PORT SANILAC, SANDUSKY, AND SNOVER. IN ADDITION, SEE ANSWER TO PART V, LINE 3 ABOVE. EXAMPLES OF SERVICE PROVIDED BASED ON COMMUNITY NEED ARE GERIATRICS PROGRAM, IMMUNIZATIONS, SPORTS PHYSICALS, SENIOR FAIR, HEALTH FAIRS, FIRST AID BOOTH AND DIABETIC CLASSES. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE EVERY UNINSURED PATIENT, THAT INCURS MORE THAN 1,000 IN MEDICAL EXPENSES, RECEIVES A CHARITY CARE/FINANCIAL ASSISTANCE APPLICATION, A MEDICAID APPLICATION, AND HUMAN SERVICES REFERRAL. ALL OTHER UNINSURED OR UNDER INSURED PATIENTS MAY REQUEST A CHARITY CARE/FINANCIAL ASSISTANCE APPLICATION AT ANY TIME. INSURANCE AND SELF PAY BROCHURES ARE AVAILABLE THROUTHOUT THE HOSIPTAL. IN ADDITION, THE SOCIAL WORKER WILL ASSIST PATIENTS WHO NEED HELP IN APPLYING FOR GOVERNMENT ASSISTANCE PROGRAMS. PART VI, LINE 4 - COMMUNITY INFORMATION MCKENZIE MEMORIAL HOSPITAL IS LOCATED IN SANILAC COUNTY WHICH HAS A POPULATION OF APPROXIMATELY 41,587. SANILAC COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES. THE UNEMPLOYMENT RATE IN SANILAC COUNTY IS BETWEEN 6.01-6.9%. X X X false false false false false false false false false DR WILLIAM STARBIRD MARLETTE PHYSICIAN 241925 32190 274115 DAN BABCOCK MARLETTE CEO 184422 17500 201922 STEVE BARNETT MCKENZIE CEO/PRES 177640 6945 14944 199529 MARK ENGLISH CHIEF OF STAFF 168599 6349 19179 194127 DR ALFREDO DOMINGO PHYSICIAN 282888 282888 DR JAMES SAMS PHYSICIAN 213688 7756 5813 227257 DR MICHAEL MERKLER PHYSICIAN 207067 7834 9168 224069 DR MATTHEW GORMLEY PHYSICIAN 195399 7144 17985 220528 GINA PATTERSON PHARMACY DIRECTOR 126905 27276 5476 15492 147873 27276 DR MELANIE KRAMER PHYSICIAN 123751 8835 132586 BARNETT ANESTESIA INC CEO'S SPOUSE 101575 CRNA SERVICES false FORM 990, PAGE 6, PART VI, LINE 6 CLASSES OF MEMBERS THAT MAKE UP THE BOARD OF DIRECTORS FORM 990, PAGE 6, PART VI, LINE 7A BOARD MEMBERS MUST BE APPROVED BY THE BOARD OF BLUE WATER HEALTHCARE NETWORK TO BECOME BOARD MEMBERS. FORM 990, PAGE 6, PART VI, LINE 7B BLUE WATER HEALTHCARE NETWORK MUST APPROVE ANY FINANCIAL TRANSACTIONS ABOVE ONE MILLION DOLLARS BEFORE ANY ACTION CAN BE TAKEN BY THE BOARD OF DIRECTORS OF MCKENZIE MEMORIAL HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS REVIEWED BY THE FINANCE COMMITTEE FOR APPROVAL AND IS THEN SUBMITTED TO THE FULL BOARD FOR APPROVAL PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 12C BOARD MEMBERS AND ALL COMMITTEES MEMBERS ARE REQUIRED TO FILL OUT AND SIGN THE ANNUAL CONFLICT OF INTEREST POLICY FORM. IN THE EVENT OF A CONFLICT APPLICABLE BOARD MEMBERS MUST ABSTAIN FROM THE VOTE. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION OF THE CEO/PRESIDENT IS APPROVED BY THE FULL BOARD BASED ON THE RECOMMENDATION OF THE EXECUTIVE COMMITTEE THROUGH EXECUTIVE SURVEY INFORMATION. ANY EXECUTIVE BONUSES ARE APPROVED BY THE BOARD AT THE END OF A FISCAL YEAR BASED ON GOALS AND SUCCESS OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE FULL BOARD THROUGH RECOMMENDATIONS BASED ON COMPENSATION SURVEYS AND APPROVAL OF THE HOSPITAL'S ANNUAL BUDGET. BONUS AMOUNTS ARE IN THE CONTRACTS APPROVED BY THE FULL BOARD. FORM 990, PAGE 6, PART VI, LINE 19 THE HOSPITALS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION AT THE PRESIDENT/CEO'S OFFICE FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL SERVICES 2,532,626 0 0 MEDICAL SERVICE CONTRACTS 241,575 0 0 ADMINISTRATIVE PROFESSIONAL 0 372,353 0 ADMINISTRATIVE SERVICE CONT. 0 31,695 0 AQUA AEROBIC INSTRUCTIONS 0 19,992 0 FORM 990, PART XI, LINE 9 INTEREST INCOME -24,883 CONTRIBUTIONS -62,439 CONTRIBUTIONS RELEASED FROM TEMP. RESTRICTED NET ASSETS -8,958 INTEREST FROM TEMPORARY RESTRICITIONS -48 ROUNDING 3 ROUNDING 9 FORM 990, PART XI, LINE 9 96,316 MCKENIZE HEALTHCARE CORPORATION 120 DELAWARE STREET SANDUSKY MI 48471 382702946 HEALTHCARE MI 501C3 3 ITSELF false SANILAC HEALTHCARE CORP 120 DELAWARE STEET SANDUSKY MI 48471 382702948 PHARMACY MI 501C3 3 MCKENIZE HEALTHCARE CORPORATION false MARLETTE REGIONAL HOSPITAL 2770 MAIN STREET PO BOX 307 MARLETTE MI 48453 381507302 HEALTHCARE MI 501C3 3 UHP false UNITED HEALTHCARE PARTNERS 120 DELAWARE STREET SANDUSKY MI 48471 465444203 HEALTHCARE MI 501C3 3 ITSELF false SANILAC SERVICES INC 78 SOUTH ELK SANDUSKY MI 48471 382774983 PHARMACY MI MCKENIZE HEALTHCARE CORPORATION C CORP false false false false false false false false false false false true false false false true true true false false SANILAC SERVICES INC SANILAC PHARMACY K 15000 FMV SANILAC SERVICES INC SANILAC PHARMACY P 9811 COST BASIS SANILAC SERVICES INC SANILAC PHARMACY Q 90000 COST BASIS MARLETE REGIONAL HOSPITAL O 160895 COST BASIS MARLETTE REGIONAL HOSPITAL O 34393 COST BASIS