COREWELL HEALTH: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-1360562)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-17
- IRS object ID
- 201542299349302499
- Schema version
- 2013v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-17T14:52:09-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 TRADE CENTRE WAY STE 300 | AddressLine1 |
| City | PORTAGE | City |
| State | MI | State |
| ZIP Code | 49002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381360562 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PENN | BusinessNameControlTxt |
| Phone | 2699453451 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 WEST GREEN STREET | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CONNIE S DOWNS | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2699453451 | PhoneNum |
| Signature | 2015-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CAROL LALONDE CPA | PreparerPersonNm |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK HEALTH SYSTEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CONNIE S DOWNS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 WEST GREEN STREET | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $75,845,372 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PENNOCKHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL'S PRIMARY MISSION IS TO PROVIDE HEALTHCARE SERVICES TO THE CITIZENS OF BARRY COUNTY. ALL ACTIVITIES ASSOCIATED WITH THIS PURPOSE ARE INCLUDED IN DETERMINATION OF THE OPERATING INCOME. NET ASSETS OF THE HOSPITAL ARE GENERALLY UNRESTRICTED AND ARE AVAILABLE FOR THE DELIVERY OF HEALTHCARE SERVICES, WITH THE EXCEPTION OF CONTRIBUTIONS FROM INDIVIDUAL DONORS, WHICH ARE TEMPORARILY RESTRICTED FOR THE PURPOSE INTENDED BY THE DONOR. THE HOSPITAL PROVIDES CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY RECEIVE CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 678 | TotalEmployeeCnt |
| Total Volunteers | 124 | TotalVolunteersCnt |
| Total Gross UBI | $110,744 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $41,441 | PYContributionsGrantsAmt |
| CY Contributions Grants | $20,579 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $59,292,525 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $62,439,958 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,756,875 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,368,548 | CYInvestmentIncomeAmt |
| PY Other Revenue | $447,515 | PYOtherRevenueAmt |
| CY Other Revenue | $568,066 | CYOtherRevenueAmt |
| PY Total Revenue | $61,538,356 | PYTotalRevenueAmt |
| CY Total Revenue | $71,397,151 | 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 | $30,429,164 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,926,021 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,472,181 | PYOtherExpensesAmt |
| CY Other Expenses | $33,961,000 | CYOtherExpensesAmt |
| PY Total Expenses | $61,901,345 | PYTotalExpensesAmt |
| CY Total Expenses | $68,887,021 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$362,989 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,510,130 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $97,838,476 | TotalAssetsBOYAmt |
| Total Assets EOY | $108,322,226 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,900,025 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,295,604 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $83,938,451 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $89,026,622 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PENNOCK HOSPITAL'S MISSION IS TO PROVIDE QUALITY HEALTH SERVICES IN A PERSONAL, PROFESSIONAL AND PROGRESSIVE MANNER IN PARTNERSHIP WITH THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $49,519,411 | ExpenseAmt |
| Revenue | $62,439,958 | RevenueAmt |
| Desc | PENNOCK CONTINUES TO INVEST IN PHYSICIAN INTEGRATION IN ORDER TO BETTER SERVE THE RURAL SECTIONS OF THE MARKET. PRIMARY CARE PHYSICIAN ADJUSMENTS AND GROWTH OCCURRED IN BARRY COUNTY. PENNOCK HOSPITAL ADDED 4 NEW PHYSICIAN PRACTICES THIS YEAR. ADVANCED ORTHOPEDIC AND PAIN INSTITUTE (AOPI), LAKEWOOD FAMILY MEDICINE, HOPKINS FAMILY MEDICINE, AND DELTON FAMILY MEDICINE. | Desc |
| Total Program Service Expenses | $49,519,411 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 64 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 678 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONNIE S DOWNS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2699483122 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 W GREEN ST | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MAGGIE COLEMAN | |||||||
| CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID BAUM | |||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRAD JOHNSON CPA | |||||||
| VICE CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JEFF WEIDEN | |||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NANCY GOODIN | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| BONNIE HILDRETH | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DAN KING | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JAMES HORTON DO | |||||||
| CHIEF OF STAFF | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| KIMBERLY NORRIS MD | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| NATHAN TAGG | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| SAM WATSON | |||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS NOAH MD | |||||||
| VICE CHIEF OF STAFF/ NON-VOTING | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| SHERYL LEWIS BLAKE | |||||||
| CEO | 40.00 | Yes (X) | $337,698 | $0 | $39,254 | ||
| CONNIE S DOWNS | |||||||
| CFO | 40.00 | Yes (X) | $209,716 | $0 | $23,073 | ||
| DOUGLAS SMENDIK | |||||||
| CMO | 40.00 | Yes (X) | $50,004 | $0 | $0 | ||
| CARLA WILSON NEIL | |||||||
| COO | 40.00 | Yes (X) | $191,978 | $0 | $15,242 | ||
| STEVE A MARZOLF | |||||||
| CHIEF NURSING OFFICER | 40.00 | Yes (X) | $151,300 | $0 | $31,724 | ||
| JAMES WINCEK | |||||||
| VP SUPPORT SERVICES | 40.00 | Yes (X) | $136,929 | $0 | $6,894 | ||
| BOB DAVIS | |||||||
| EXECUTIVE DIRECTOR OF THE PHYSICIAN NETWORK | 40.00 | Yes (X) | $125,159 | $0 | $17,556 | ||
| BRIDGIT BRENNAN MD | |||||||
| PHYSICIAN | 40.00 | $360,536 | $0 | $31,487 | Yes (X) | ||
| MAX RAPPAPORT MD | |||||||
| PHYSICIAN | 40.00 | $342,089 | $0 | $26,387 | Yes (X) | ||
| EDWARD ERBTER | |||||||
| PHYSICIAN | 40.00 | $273,133 | $0 | $23,905 | Yes (X) | ||
| ANDREW PARSONS MD | |||||||
| PHYSICIAN | 40.00 | $294,946 | $0 | $31,342 | Yes (X) | ||
| MATTHEW GARBER | |||||||
| PHYSICIAN | 40.00 | $237,329 | $0 | $27,509 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,710,817 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $274,373 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROGRESSIVE BUILDING SERVICES INC | |||||
| PO BOX 88235 | KENTWOOD | MI | 49518 | HOUSE KEEPING SERVICES | $564,807 |
| SPECTRUM HEALTH | |||||
| 100 MICHIGAN | GRAND RAPIDS | MI | 49503 | REFERENCE LAB/SLEEP STUDY | $413,647 |
| HASTINGS ANESTHESIOLOGY PC | |||||
| PO BOX 4095 | KALAMAZOO | MI | 49003 | ANASTHESIA SERVICES | $338,800 |
| HDR ARCHITECTURE INC | |||||
| PO BOX 3480 | OMAHA | NE | 68103 | ARCHITECTURAL SERVICES | $286,294 |
| ARAMARK CORPORATION | |||||
| 10510 TWIN LAKES PARKWAY | CHARLOTTE | NC | 28269 | REPAIR SERVICES | $220,630 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $20,579 | AllOtherContributionsAmt |
| Total Contributions | $20,579 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $61,550,361 | $61,550,361 |
| MEANINGFUL USE PROJECTS | 621110 | $889,597 | $889,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $62,439,958 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $263,542 | TotalRevenueColumnAmt |
| Exclusion | $263,542 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $783,440 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $859,562 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$76,122 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$76,122 | TotalRevenueColumnAmt |
| Exclusion | -$76,122 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,086,651 | SecuritiesAmt |
| Other | $4,607,014 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,588,659 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,497,992 | SecuritiesAmt |
| Other | $4,607,014 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,105,006 | TotalRevenueColumnAmt |
| Exclusion | $8,105,006 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA REVENUE | 722100 | $302,847 | $302,847 | |
| MISCELLANEOUS | 900099 | $230,597 | $230,597 | |
| LAB COURIER SERVICE | 621500 | $110,744 | $110,744 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $644,188 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,397,151 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $62,439,958 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $110,744 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,825,870 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,562,549 | TotalAmt |
| Program Services | $1,421,920 | ProgramServicesAmt |
| Management And General | $140,629 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,234,762 | TotalAmt |
| Program Services | $18,352,599 | ProgramServicesAmt |
| Management And General | $9,882,163 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,321,989 | TotalAmt |
| Program Services | $925,392 | ProgramServicesAmt |
| Management And General | $396,597 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,835,125 | TotalAmt |
| Program Services | $1,284,547 | ProgramServicesAmt |
| Management And General | $550,578 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,971,596 | TotalAmt |
| Program Services | $1,380,118 | ProgramServicesAmt |
| Management And General | $591,478 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,673 | TotalAmt |
| Program Services | $199,673 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,295 | TotalAmt |
| Management And General | $121,295 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,876 | TotalAmt |
| Management And General | $4,876 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,913 | TotalAmt |
| Management And General | $229,913 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,707,595 | TotalAmt |
| Program Services | $3,310,405 | ProgramServicesAmt |
| Management And General | $2,397,190 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,575 | TotalAmt |
| Program Services | $32,144 | ProgramServicesAmt |
| Management And General | $96,431 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,685,799 | TotalAmt |
| Program Services | $1,433,715 | ProgramServicesAmt |
| Management And General | $252,084 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,876,985 | TotalAmt |
| Program Services | $1,431,822 | ProgramServicesAmt |
| Management And General | $445,163 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,012 | TotalAmt |
| Program Services | $187,858 | ProgramServicesAmt |
| Management And General | $101,154 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,317 | TotalAmt |
| Program Services | $235,317 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,761,361 | TotalAmt |
| Program Services | $3,197,157 | ProgramServicesAmt |
| Management And General | $564,204 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,177 | TotalAmt |
| Program Services | $282,865 | ProgramServicesAmt |
| Management And General | $152,312 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $9,792,209 | $9,119,704 | $672,505 |
| BAD DEBTS | $5,685,232 | $5,685,232 | |
| QUALITY ASSURANCE ASSES | $2,371,892 | $2,371,892 | |
| MAINTENANCE AND REPAIRS | $1,260,946 | $1,066,317 | $194,629 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,143 | TotalAmt |
| Program Services | -$27,374 | ProgramServicesAmt |
| Management And General | $202,517 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,887,021 | TotalAmt |
| Program Services | $49,519,411 | ProgramServicesAmt |
| Management And General | $19,367,610 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,059 | BOYAmt |
| EOY | $130,511 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,580,458 | BOYAmt |
| EOY | $6,293,541 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,987,147 | BOYAmt |
| EOY | $8,453,773 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,500 | BOYAmt |
| EOY | $56,500 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,417,999 | BOYAmt |
| EOY | $6,092,948 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,767 | BOYAmt |
| EOY | $998,923 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $510,094 | BOYAmt |
| EOY | $559,292 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $53,930,968 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,194,443 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,129,367 | BOYAmt |
| EOY | $24,736,525 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,355,858 | BOYAmt |
| EOY | $59,400,385 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $630,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $881,227 | BOYAmt |
| EOY | $969,828 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,838,476 | BOYAmt |
| EOY | $108,322,226 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,669,308 | BOYAmt |
| EOY | $5,850,607 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,933,651 | BOYAmt |
| EOY | $11,930,362 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,297,066 | BOYAmt |
| EOY | $1,514,635 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,900,025 | BOYAmt |
| EOY | $19,295,604 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,130,015 | BOYAmt |
| EOY | $88,207,439 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $808,436 | BOYAmt |
| EOY | $819,183 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,938,451 | BOYAmt |
| EOY | $89,026,622 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,838,476 | BOYAmt |
| EOY | $108,322,226 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,510,130 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,578,041 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,876 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,876 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF DUES PAID TO MHA AND AHA ARE ALLOCATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,703,430 | OtherCostOrOtherBasisAmt |
| Book Value | $3,703,430 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,182,273 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,483,036 | DepreciationAmt |
| Book Value | $13,699,237 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,745,889 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,028,423 | DepreciationAmt |
| Book Value | $717,466 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,342,173 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,682,984 | DepreciationAmt |
| Book Value | $5,659,189 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $957,203 | OtherCostOrOtherBasisAmt |
| Book Value | $957,203 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,736,525 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $1,514,635 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,514,635 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $65,482,006 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $65,482,006 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $229,913 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $5,685,232 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,915,145 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $71,397,151 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $62,971,876 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $62,971,876 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $229,913 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $5,685,232 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $5,915,145 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $68,887,021 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE SYSTEM, THE FOUNDATION, AND THE HOSPITAL ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SYSTEM'S, FOUNDATION'S, AND HOSPITAL'S TAX RETURNS ARE NOT SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR YEARS BEGINNING PRIOR TO OCTOBER 1, 2009. VENTURES IS A FOR-PROFIT ORGANIZATION. TAXES PAID BY VENTURES ARE INSIGNIFICANT AND ARE INCLUDED IN THE OPERATING EXPENSES OF THE SYSTEM. THE SYSTEM HAS ADOPTED ACCOUNTING STANDARDS RELATED TO UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, REVIEWED ALL TAX POSITIONS. THE EVALUATED POTENTIAL EXPOSURE RELATED TO UNCERTAIN TAX POSITIONS WAS FOUND TO BE IMMATERIAL. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT NETTED WITH REVENUE 5,685,232. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT NETTED WITH REVENUE 5,685,232. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $800,570 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $800,570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $8,930,104 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,641,945 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,288,159 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05200 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $305,644 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $829,102 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$523,458 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $10,036,318 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,471,047 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,565,271 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 96 | ActivitiesOrProgramsCnt |
| Persons Served | 2485 | PersonsServedCnt |
| Total Community Benefit Expns | $19,055 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,055 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 2 | PersonsServedCnt |
| Total Community Benefit Expns | $1,991 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,991 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 132 | ActivitiesOrProgramsCnt |
| Persons Served | 15827 | PersonsServedCnt |
| Total Community Benefit Expns | $66,586 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $66,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 231 | ActivitiesOrProgramsCnt |
| Persons Served | 18314 | PersonsServedCnt |
| Total Community Benefit Expns | $87,632 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $87,632 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 235 | ActivitiesOrProgramsCnt |
| Persons Served | 18314 | PersonsServedCnt |
| Total Community Benefit Expns | $10,123,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,471,047 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,652,903 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06610 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $207,946 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $207,946 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 99 | ActivitiesOrProgramsCnt |
| Persons Served | 786 | PersonsServedCnt |
| Total Community Benefit Expns | $39,286 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $39,286 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 80 | PersonsServedCnt |
| Total Community Benefit Expns | $13,041 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,041 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 113 | ActivitiesOrProgramsCnt |
| Persons Served | 866 | PersonsServedCnt |
| Total Community Benefit Expns | $260,273 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $260,273 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,685,232 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $132,862 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,198,579 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,893,263 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $305,316 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 BARRY HEALTH PARTNERS LTD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | TO INTEGRATE PHYSICIAN AND HOSPITAL CLINICAL PRACTICES AND PAYOR CONTRACTIN | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.50000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 W GREEN ST | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PENNOCKHEALTH.COM | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PENNOCK HOSPITAL | PART V, SECTION B, LINE 3: PENNOCK HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE UTILIZING INTERNAL DATA, DATA COLLECTED FROM THOMPSON REUTERS, MICHIGAN HEALTH AND HOSPITAL ASSOCIATION, BARRY EATON HEALTH DEPARTMENT, LOCAL SOCIAL SERVICE AGENCIES, SCHOOL SYSTEMS, NATIONAL HEALTH ASSOCIATIONS (AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES), AND OUR PAYORS. PENNOCK COLLECTS DATA INTERNALLY BASED ON INPATIENT AND OUTPATIENT STATISTICS. THOMPSON REUTERS PROVIDES DATA REGARDING THE SERVICES BEING USED BY THE POPULATION WITHIN THE SERVICE AREA SUPPORTED BY PENNOCK HOSPITAL, INCLUDING PROJECTED POPULATION GROWTH TRENDS BY AGE AND SEX. THIS HELPS US TO EXAMINE THE PATIENT NEEDS AT A CLOSER LEVEL. LOCAL SOCIAL SERVICES AGENCIES AND SCHOOL SYSTEMS HELP US IDENTIFY SOCIOECONOMIC FACTORS CONTRIBUTING TO THE IDENTIFIED HEALTH STATUS OF OUR SERVICE AREA. THE NATIONAL HEALTH ASSOCIATIONS PROVIDE DATA AS RELATED TO THEIR DISEASE SPECIFIC AREA FOR OUR COUNTY. |
| PENNOCK HOSPITAL | PART V, SECTION B, LINE 5D: THROUGH THE WORKGROUP MEMBERS AND THEIR RELATED AGENCIES. |
| PENNOCK HOSPITAL | PART V, SECTION B, LINE 7: THE TOP TEN LEADING CAUSES OF DEATH IN BARRY COUNTY ARE CANCER, HEART DISEASE, DIABETES-RELATED, CHRONIC LOWER RESPIRATORY, STROKE, ALZHEIMERS DISEASE, UNINTENTIONAL INJURY, PNEMONIA & INFLUENZA, INTENTIONAL SELF-HARM (SUICIDE), KIDNEY DISEASE, CHRONIC LIVER DISEASE, INFANT MORTALITY, SEPTICEMIA, ALCOHOL-INDUCED, AIDS, AND ASSAULT (HOMICIDE). DISEASE STATE OR CAUSE OF DEATH WERE NOT CHOSEN BECAUSE OF THE FOCUS ON PREVENTION OF CHRONIC DISEASE THROUGH CHANGING BEHAVIORS AND PREVENTING ILLNESS. ADDITIONALLY, PENNOCK HEALTH SERVICES EXPANDED NEPHROLOGY, OFFERS DIABETIC EDUCATION AND HEALTH COACHES TO ADDRESS HEALTH BEHAVIORS AND MANAGEMENT, AND ALL PENNOCK PHYSICIAN NETWORK CLINICS AND MOST OF THE PHYSICIAN OFFICES ARE PATIENT CENTERED MEDICAL HOME (PCMH) DESIGNATED WHERE THEY HAVE A STRONG FOCUS ON PREVENTION AND DISEASE MANAGEMENT. IN 2012, PENNOCK BROUGHT DIALYSIS SERVICES TO BARRY COUNTY. PENNOCK IS EXPANDING HEART AND VASCULAR SERVICES, AND HAS A STRATEGIC INITIATIVE ALREADY IN PLACE TO EXPAND CANCER SERVICES. TOBACCO USE REDUCTION HAS A COALITION WORKING ON THIS INITIATIVE; THE STEERING COMMITTEE FELT IT NEEDED A STRONGER PARTNERSHIP WITH PENNOCK. BARRY SUBSTANCE ABUSE TASKFORCE ADDRESSES ALCOHOL AND DRUG USE. PENNOCK AIDS IN AWARENESS AND THE PENNOCK FOUNDATION PROVIDES SOME FUNDING. IN ADDITION, A GROUP HAS FORMED TO REDUCE SUICIDE. PENNOCK AND THE PENNOCK FOUNDATION ASSIST WITH RESOURCE AWARENESS AND FUNDING. |
| PENNOCK HOSPITAL | PART V, SECTION B, LINE 20D: PENNOCK HEALTH SERVICES PROVIDES CHARITY CARE TO INDIVIDUALS UNABLE TO PAY THEIR BILL. ALL MEDICALLY NECESSARY SERVICES RENDERED BY PENNOCK HOSPITAL, PENNOCK HOMECARE/HOSPICE AND PENNOCK FAMILY MEDICINE MAY QUALIFY FOR CHARITY CARE. PATIENTS MAY REQUEST A WRITTEN DETERMINATION OF ELIGIBILITY THROUGH PENNOCK HOSPITAL'S PATIENT FINANCIAL SERVICES DEPARTMENT. ELIGIBILITY DETERMINATIONS WILL BE MADE WITHIN THIRTY (30) DAYS OF THE COMPLETED REQUEST. WE WILL USE THE INFORMATION THAT IS PROVIDED ON THE 'CHARITY CARE APPLICATION' AND THE 'CHARITY CARE SLIDING SCALE' TO MAKE A CHARITY CARE DETERMINATION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 15 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| STATE STREET URGENT CARE CENTER | ||||
| 1108 W STATE STREET | HASTINGS | MI | 49058 | URGENT CARE CENTER |
| PENNOCK HOME HEALTH | ||||
| 1230 W STATE STREET | HASTINGS | MI | 49058 | HOME HEALTH CARE AGENCY |
| HASTINGS GENERAL SURGEONS | ||||
| 1009 W GREEN ST | HASTINGS | MI | 49058 | SURGEON PRACTICE OFFICE |
| GUN LAKE FAMILY MEDICINE | ||||
| 77 124TH AVE | SHELBYVILLE | MI | 49344 | FAMILY PRACTICE OFFICE |
| PENNOCK HOSPICE | ||||
| 1230 W STATE STREET | HASTINGS | MI | 49058 | OUTPATIENT HOSPICE CARE |
| CLARKSVILLE FAMILY MEDICINE | ||||
| 155 E CROSS ST | CLARKSVILLE | MI | 48815 | FAMILY PRACTICE OFFICE |
| CALEDONIA FAMILY MEDICINE | ||||
| 9090 RODGERS CT | CALEDONIA | MI | 49316 | FAMILY PRACTICE OFFICE |
| HASTINGS FAMILY MEDICINE | ||||
| 1009 W GREEN ST | HASTINGS | MI | 49058 | FAMILY PRACTICE OFFICE |
| NASHVILLE FAMILY MEDICINE | ||||
| 750 DURKEE | NASHVILLE | MI | 49073 | FAMILY PRACTICE OFFICE |
| DR DEGOA | ||||
| 1108 W STATE STREET | HASTINGS | MI | 49058 | OBGYN |
| ADVANCED ORTHOPEDIC AND PAIN INSTITUTE | ||||
| 840 COOK RD | HASTINGS | MI | 49058 | SURGEON PRACTICE OFFICE |
| WOMEN'S HEALTH FIRST | ||||
| 1108 W STATE STREET | HASTINGS | MI | 49058 | OBGYN |
| LAKEWOOD FAMILY MEDICINE | ||||
| 4294 LAUREL DRIVE | LAKE ODESSA | MI | 48849 | FAMILY PRACTICE OFFICE |
| HOPKINS FAMILY MEDICINE | ||||
| 130 W MAIN STREET | HOPKINS | MI | 49328 | FAMILY PRACTICE OFFICE |
| DELTON OFFICE | ||||
| 11275 SPRAGUE RD | DELTON | MI | 49046 | FAMILY PRACTICE OFFICE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | PENNOCK USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR CHARITY CARE. WE DO NOT USE AN ASSET BASED TEST OR OTHER THRESHOLD. |
| PART I, LINE 7: | THE COST TO CHARGE RATIO WAS USED TO DETERMINE PATIENT SERVICE COSTS. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,685,232. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM 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 PROVISIONS FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA RELATED TO THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COST TO CHARGE RATIO WAS USED TO DETERMINE BAD DEBT AT COST REPORTED ON LINE 2. THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING THE BARRY COUNTY HEALTH PLAN CHARGES. THE CRITERIA USED FOR DETERMINING PATIENT ELIGIBILITY UNDER THE BARRY COUNTY HEALTH PLAN FALLS WITHIN OUR CHARITY CARE POLICY. |
| PART III, LINE 8: | PENNOCK HOSPITAL DOES NOT EXPERIENCE A MEDICARE SHORTFALL. THE MEDICARE COST REPORT WAS USED TO REPORT MEDICARE ALLOWABLE COSTS. |
| PART III, LINE 9B: | IT IS THE POLICY OF PHS, TO ACKNOWLEDGE AND UNDERSTAND THAT ALL ITS PATIENTS ARE NOT EQUALLY CAPABLE OF WITHSTANDING THE BURDEN OF PAYMENT FOR SERVICES, EITHER BY THEMSELVES OR THROUGH A THIRD PARTY INSURANCE CARRIER. PHS, THROUGH THE PATIENT FINANCIAL SERVICES (PFS) DEPARTMENT, HAVE IMPLEMENTED DETAILED AND ROBUST POLICIES ON CHARITY (PHS CHARITY CARE POLICY) AND COLLECTIONS (PHS CREDIT/COLLECTION POLICY). ONCE THE DECISION IS MADE TO PROVIDE FINANCIAL ASSISTANCE, THE PATIENT IS NOTIFIED AND NECESSARY CHANGES OR ADJUSTMENTS TO A PATIENT ACCOUNT ARE MADE, FOLLOWING POLICY, BY THE PHS STAFF. |
| PART VI, LINE 2: | PENNOCK HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE UTILIZING INTERNAL DATA, DATA COLLECTED FROM THOMPSON REUTERS, MICHIGAN HEALTH AND HOSPITAL ASSOCIATION, BARRY EATON HEALTH DEPARTMENT, LOCAL SOCIAL SERVICE AGENCIES, SCHOOL SYSTEMS, NATIONAL HEALTH ASSOCIATIONS (AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES), AND OUR PAYORS. PENNOCK COLLECTS DATA INTERNALLY BASED ON INPATIENT AND OUTPATIENT STATISTICS. THOMPSON REUTERS PROVIDES DATA REGARDING THE SERVICES BEING USED BY THE POPULATION WITHIN THE SERVICE AREA SUPPORTED BY PENNOCK HOSPITAL, INCLUDING PROJECTED POPULATION GROWTH TRENDS BY AGE AND SEX. THIS HELPS US TO EXAMINE THE PATIENT NEEDS AT A CLOSER LEVEL. LOCAL SOCIAL SERVICES AGENCIES AND SCHOOL SYSTEMS HELP US IDENTIFY SOCIOECONOMIC FACTORS CONTRIBUTING TO THE IDENTIFIED HEALTH STATUS OF OUR SERVICE AREA. THE NATIONAL HEALTH ASSOCIATIONS PROVIDE DATA AS RELATED TO THEIR DISEASE SPECIFIC AREA FOR OUR COUNTY. |
| PART VI, LINE 3: | FOR SCHEDULED PATIENTS, DURING THE PRE-REGISTRATION PROCESS, PATIENT FINANCIAL SERVICE COLLEAGUES MAY CONTACT PATIENTS TO DISCUSS THEIR PATIENT FINANCIAL RESPONSIBILITY, AND AT THAT TIME WILL DISCUSS ASSISTANCE, AND PAYMENT OPTIONS. FOR NON-SCHEDULED PATIENTS WHO ARE ADMITTED, PATIENT FINANCIAL SERVICE WILL MAKE EVERY EFFORT TO MEET WITH THE PATIENT AND/OR THEIR FAMILY/RESPONSIBLE PARTY. WE PROVIDE EDUCATION REGARDING GOVERNMENT-FUNDED PROGRAMS, INCLUDING MEDICARE AND MEDICAID,WITH ELIGIBILITY SPECIALISTS ON STAFF. WE ALSO WORK CLOSELY WITH COUNTY HEALTH PLAN STAFF TO IDENTIFY ELIGIBLE PATIENTS FOR SERVICES BEYOND THOSE PROVIDED AT PHS. WE ALSO EDUCATE OUR PATIENTS WITH ALL AVAILABLE PROGRAMS SPONSORED BY PHS, INCLUDING THE CHARITY POLICY AND CREDIT/COLLECTION POLICY, EXTENSION OF CREDIT THROUGH THE PENNOCK CREDIT PROGRAM OR THE HELP LOAN PROGRAM WHICH PROVIDES SHORT-TERM AND LONGER-TERM FINANCING OPTIONS. OPTIONS THAT ARE AVAILABLE ARE INCLUDED ON PRINTED MATERIALS WHICH ARE LOCATED THROUGHOUT THE COMMUNITY AT MANY FAMILY PRACTICE PHYSICIAN OFFICES, AS WELL AS AROUND THE PHS CAMPUS, AND ON THE PHS WEBSITE. |
| PART VI, LINE 4: | BARRY COUNTY, MICHIGAN IS THE COMMUNITY PENNOCK SERVES. BARRY COUNTY BOASTS 59,173 RESIDENTS, UP 5% SINCE 2000. WITH 11.8% OF THE POPULATION OVER THE AGE OF 65, BARRY COUNTY IS A RELATIVELY YOUNG COMMUNITY. BARRY COUNTY ALSO SERVES AS A STABLE COMMUTER COMMUNITY WHERE THE AVERAGE TRAVEL TIME IS APPROXIMATELY 30 MINUTES AND THE AVERAGE HOUSEHOLD INCOME IS $46,820. BARRY COUNTY IS UNIQUELY LOCATED IN THE MIDDLE OF FOUR (4) LARGER METROPOLITAN AREAS: GRAND RAPIDS, LANSING, KALAMAZOO, AND BATTLE CREEK. |
| PART VI, LINE 5: | THE MISSION OF PHS IS TO PROVIDE QUALITY HEALTH SERVICES IN A PERSONAL, PROFESSIONAL, AND PROGRESSIVE MANNER IN PARTNERSHIP WITH OUR COMMUNITY. OUR MISSION IS CLOSELY CORRELATED WITH THE HEALTH AND SOCIOECONOMIC DATA COLLECTED. THIS DATA ALONG WITH OUR MISSION ASSISTS IN STRATEGIC PLANNING EFFORTS TO ALIGN THE SERVICES PROVIDED BY PENNOCK WITH THE TRUE COMMUNITY HEALTH NEED. SPONSORSHIPS AND DONATIONS OR VOLUNTEER TIME IS DIRECTED IN THE AREAS OF HEALTH STATUS IDENTIFICATION, EVALUATION, AND EDUCATION WHERE PREVENTION OR MANAGEMENT IS TAUGHT. PENNOCK COLLEAGUES VOLUNTEER TIME AND MATERIALS TO PROVIDE HEALTH SCREENINGS, FREE OR AT A REDUCED RATED DEPENDING ON THE SERVICE BEING PROVIDED. COLLEAGUES ALSO COLLABORATE WITH LOCAL BUSINESSES TO EDUCATE THEIR EMPLOYEES ON HEALTH IMPROVEMENT AND COST SAVINGS OPTIONS TO EMPLOYERS, WHICH HELPS THE LOCAL ECONOMY AND IMPROVES OVERALL HEALTH OF OUR WORKFORCE. FINALLY, PENNOCK PROVIDES A LOCATION FREE OF CHARGE TO HOUSE THE BARRY COMMUNITY FREE CLINIC AND HABITAT FOR HUMANITY TO ALLEVIATE OVERHEAD AND ALLOW THESE SERVICES TO ASSIST THOSE IN NEED IN OUR COUNTY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHERYL LEWIS BLAKE | ||||||||||||||
| CEO | $292,372 | $0 | $0 | $0 | $45,326 | $0 | $12,750 | $0 | $26,504 | $0 | $376,952 | $0 | $0 | $0 |
| CONNIE S DOWNS | ||||||||||||||
| CFO | $190,566 | $0 | $0 | $0 | $19,150 | $0 | $7,401 | $0 | $15,672 | $0 | $232,789 | $0 | $0 | $0 |
| CARLA WILSON NEIL | ||||||||||||||
| COO | $174,794 | $0 | $0 | $0 | $17,184 | $0 | $12,281 | $0 | $2,961 | $0 | $207,220 | $0 | $0 | $0 |
| STEVE A MARZOLF | ||||||||||||||
| CHIEF NURSING OFFICER | $139,910 | $0 | $0 | $0 | $11,390 | $0 | $5,596 | $0 | $26,128 | $0 | $183,024 | $0 | $0 | $0 |
| BRIDGIT BRENNAN MD | ||||||||||||||
| PHYSICIAN | $285,230 | $0 | $33,300 | $0 | $42,006 | $0 | $10,200 | $0 | $21,287 | $0 | $392,023 | $0 | $0 | $0 |
| MAX RAPPAPORT MD | ||||||||||||||
| PHYSICIAN | $285,230 | $0 | $33,300 | $0 | $23,559 | $0 | $5,100 | $0 | $21,287 | $0 | $368,476 | $0 | $0 | $0 |
| EDWARD ERBTER | ||||||||||||||
| PHYSICIAN | $225,014 | $0 | $0 | $0 | $48,119 | $0 | $1,212 | $0 | $22,693 | $0 | $297,038 | $0 | $0 | $0 |
| ANDREW PARSONS MD | ||||||||||||||
| PHYSICIAN | $235,645 | $0 | $33,300 | $0 | $26,001 | $0 | $10,200 | $0 | $21,142 | $0 | $326,288 | $0 | $0 | $0 |
| MATTHEW GARBER | ||||||||||||||
| PHYSICIAN | $236,339 | $0 | $0 | $0 | $990 | $0 | $5,650 | $0 | $21,859 | $0 | $264,838 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | THE HEALTH AND WELLNESS CENTER IS AVAILABLE TO ALL BOARD MEMBERS AND IS TREATED AS TAXABLE COMPENSATION PER POLICY, DATED 9/28/2010. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| MICHIGAN STATE HOSPITAL FINANCE AUTHORITY | ||||||||
| A | 382889417 | 59465E3R2 | 2003-01-08 | $4,300,000 | HEALTHCARE EQUIPMENT | 0 | 0 | Yes (1) |
| MICHIGAN STATE HOSPITAL FINANCE AUTHORITY | ||||||||
| B | 382889417 | 59465E5B5 | 2003-10-22 | $6,000,000 | HEALTHCARE EQUIPMENT | 0 | 0 | Yes (1) |
| MICHIGAN STATE HOSPITAL FINANCE AUTHORITY | ||||||||
| C | 382889417 | 59465E5V1 | 2003-12-10 | $3,832,599 | HEALTHCARE EQUIPMENT | 0 | 0 | Yes (1) |
| MICHIGAN STATE HOSPITAL FINANCE AUTHORITY | ||||||||
| D | 382889417 | 59465HEP7 | 2007-03-28 | $3,031,165 | HEALTHCARE EQUIPMENT | 0 | 0 | Yes (1) |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|
| A | $3,526,116 | $4,300,000 | $4,300,000 | 2003 | 0 | 0 | Yes (1) | Yes (1) |
| B | $5,746,827 | $6,000,000 | $6,000,000 | 2005 | 0 | 0 | Yes (1) | Yes (1) |
| C | $3,832,599 | $3,832,599 | $3,832,599 | 2006 | 0 | 0 | Yes (1) | Yes (1) |
| D | $1,649,335 | $3,031,165 | $3,031,165 | 2012 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| D | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| C | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| D | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
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 | MICHIGAN FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 800596186 | BondIssuerEIN |
| CUSIP | 59447PDT5 | CUSIPNum |
| Bond Issued | 2011-03-23 | BondIssuedDt |
| Issue Price | $5,618,998 | IssuePriceAmt |
| Purpose | HEALTHCARE EQUIPMENT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | Yes (1) | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,094,234 | RetiredAmt |
| Total Proceeds | $5,618,998 | TotalProceedsAmt |
| Capital Expenditures | $5,618,998 | CapitalExpendituresAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| 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 | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | 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 | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CONNIE DOWNS CFO | PersonNm |
| Loan Purpose | HIGHER EDUCATION | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $56,500 | OriginalPrincipalAmt |
| Balance Due | $56,500 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $56,500 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HASTINGS CITY BANK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | NANCY GOODIN, BOARD MEMBER OF HOSPITAL AND DIRECTOR OF MARKETING AT BANK | RelationshipDescriptionTxt |
| Transaction | $83,770 | TransactionAmt |
| Transaction | INVESTMENT FEES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | PENNOCK HOSPITAL ADDED 4 NEW PHYSICIAN PRACTICES THIS YEAR. ADVANCED ORTHOPEDIC AND PAIN INSTITUTE (AOPI), LAKEWOOD FAMILY MEDICINE, HOPKINS FAMILY MEDICINE, AND DELTON FAMILY MEDICINE . AOPI WAS AN EXISTING ORTHOPEDIC PRACTICE IN HASTINGS, MI, THIS PRACTICE WAS ACQUIRED BY THE HOSPITAL IN ORDER TO CONTINUE TO PROVIDE ORTHOPEDIC SURGICAL PROCEDURES AND PAIN MANAGEMENT TO THE CITIZENS OF BARRY COUNTY. LAKEWOOD FAMILY MEDICINE WAS AN EXISTING FAMILY MEDICINE PRACTICE IN LAKE ODESSA, MI, WHICH PENNOCK ACQUIRED IN ORDER TO CONTINUE TO PROVIDE SERVICES TO THE CITIZENS OF SOUTHERN IONIA COUNTY. PENNOCK RECRUITED PHYSICIANS TO WORK IN HOPKINS AND DELTON IN ORDER TO PROVIDE NEEDED FAMILY MEDICINE SERVICES TO CITIZENS IN ALLEGAN COUNTY AND SOUTHERN BARRY COUNTY, RESPECTIVELY. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF TRUSTEES HAVE RECEIVED TRAINING, CONDUCTED BY OUR INDEPENDENT PUBLIC ACCOUNTANTS ON THE RULES AND REQUIREMENTS OF THE IRS FORM 990. ON AUGUST 14, 2015 THE COMPLETED IRS FORM 990 WAS MADE AVAILABLE FOR REVIEW BY THE BOARD AND THE CHIEF FINANICAL OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY BOARD MEMBERS. MEMBERS ARE RESPONSIBLE FOR FULL DISCLOSURE OF POTENTIAL CONFLICTS WHICH ARE DOCUMENTED IN THE MINUTES. ANY INDIVIDUAL WITH A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING ON ANY RELEVANT ITEMS. |
| FORM 990, PART VI, SECTION B, LINE 15 | PENNOCK USES SALARY SURVEYS ALONG WITH HIRING A CONSULTING COMPANY IN ASSISTING WITH SETTING WAGES FOR THE OFFICER'S AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE IS COMPRISED OF THREE BOARD MEMBERS TO REVIEW COMPENSATION AND ADVISE THE FULL BOARD OF SALARIES, RAISES, AND BENEFITS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2014. ALL DISCUSSIONS FROM THE COMPENSATION COMMITTEE ARE DOCUMENTED IN MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND 990 ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN PROCESS FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PENNOCK FOUNDATION | |||||||||||
| 1009 WEST GREEN STREET | HASTINGS | MI | 49058 | 382713275 | FOUNDATION | MI | 501(C)(3) | LINE 11B, II | PENNOCK HEALTHCARE SYSTEMS | Yes (1) | |
| PENNOCK HEALTHCARE SYSTEM | |||||||||||
| 1009 WEST GREEN STREET | HASTINGS | MI | 49058 | 382713276 | PARENT ORGANIZATION | MI | 501(C)(3) | LINE 11B, II | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK VENTURES | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 WEST GREEN STREET | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382712819 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | 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 (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PENNOCK VENTURES | ||
| A | $17,904 | FMV |
| PENNOCK VENTURES | ||
| D | $129,752 | CASH |
| PENNOCK VENTURES | ||
| J | $30,456 | FMV |
| PENNOCK VENTURES | ||
| K | $439,883 | FMV |
| PENNOCK FOUNDATION | ||
| M | $3,924 | FMV |
| PENNOCK FOUNDATION | ||
| N | $40,768 | CASH |
| PENNOCK FOUNDATION | ||
| P | $75,124 | CASH |