COREWELL HEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-2748035)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-15
- IRS object ID
- 201402279349302475
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-15T10:44:31-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382748035 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEMORIAL HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 2699836501 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3425 LAKESHORE DR | AddressLine1 |
| City | ST JOSEPH | City |
| State | MI | State |
| ZIP Code | 49085 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY CALHOUN | Name |
| Title | VP - FINANCE & CFO | Title |
| Phone | 2699836501 | Phone |
| Date Signed | 2014-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CAROL LALONDE CPA | Name |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND CONTINUING CARE CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LOREN HAMEL MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVENUE | AddressLine1 |
| City | ST JOSEPH | City |
| State | MI | State |
| ZIP Code | 49085 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7272246 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | LAKELANDHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN THE SOUTHWEST MICHIGAN AREA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 148 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7410997 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7271889 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 52 | InvestmentIncomePriorYear |
| Investment Income Current Year | 357 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4717 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7415766 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7272246 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4586165 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4620394 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2935414 | OtherExpensePriorYear |
| Other Expenses Current Year | 2669280 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7521579 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7289674 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -105813 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -17428 | RevenuesLessExpensesCY |
| Total Assets BOY | 7371787 | TotalAssetsBOY |
| Total Assets EOY | 14393564 | TotalAssetsEOY |
| Total Liabilities BOY | 2850576 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9889781 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4521211 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4503783 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO BE SOUTHWESTERN MICHIGAN'S LEADER IN SAFE, HIGH QUALITY, PATIENT CENTERED, COMPASSIONATE, HEALTH-RELATED SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6303219 | Expense |
| Revenue | 7271889 | Revenue |
| Description | NURSING HOME OPERATIONS WERE PROVIDED TO 148 PATIENTS. | Description |
| Total Program Service Expense | 6303219 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 13 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 148 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHUCK PIECHOCKI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2694282416 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVE | AddressLine1 |
| City | ST JOSEPH | City |
| State | MI | State |
| ZIP Code | 49085 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|---|
| MICHAEL MORTIMORE | ||||||||
| CHAIRMAN | 1.00 | 5.00 | X | X | 0 | 0 | 0 | |
| KAY VARGA-SMITH | ||||||||
| VICE CHAIRMAN | 1.00 | 2.00 | X | X | 0 | 0 | 0 | |
| LYNN KELLOGG | ||||||||
| TREASURER | 1.00 | 1.00 | X | X | 0 | 0 | 0 | |
| DAVE VILLAGE | ||||||||
| SECRETARY | 1.00 | 1.00 | X | X | 0 | 0 | 0 | |
| LOREN HAMEL MD | ||||||||
| PRESIDENT & CEO | 3.00 | 52.00 | X | X | 0 | 671199 | 50637 | |
| LAURENCE HABENICHT MD | ||||||||
| DIRECTOR | 1.00 | 41.00 | X | 0 | 318557 | 22947 | ||
| DANIEL HOPP | ||||||||
| DIRECTOR | 1.00 | 17.00 | X | 0 | 0 | 0 | ||
| EWANAH JOHNSON MD | ||||||||
| DIRECTOR | 1.00 | 41.00 | X | 0 | 241898 | 34504 | ||
| MARY JO PARKER | ||||||||
| DIRECTOR | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| KEITH VANOOSTERHOUT MD | ||||||||
| DIRECTOR | 1.00 | 41.00 | X | 0 | 206885 | 22432 | ||
| SHIRLEE BENFORD | ||||||||
| DIRECTOR (PART-YEAR) | 1.00 | 1.00 | X | 0 | 0 | 0 | ||
| TIMOTHY CALHOUN | ||||||||
| VP - FINANCE & CFO | 3.00 | 47.00 | X | 0 | 367662 | 36008 | ||
| EILEEN WILLITS | ||||||||
| VP - PATIENT CARE SERVICES | 4.00 | 46.00 | 0 | 277143 | 30444 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2083344 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 196972 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REHABCARE GROUP | |||||
| PO BOX 503534 | ST LOUIS | MO | 631503534 | THERAPY SERVICES | 516937 |
| TRANE COMPANY | |||||
| 3600 PAMMEL CREEK RD | LA CROSSE | WI | 546017599 | HVAC | 337600 |
| RICHARD POSTEMA ASSOCIATES | |||||
| 1580 44TH ST SW | WYOMING | MI | 49509 | ARCHITECTURE | 277222 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621400 | 7270497 | 7270497 |
| OTHER OPERATING REVENU | 621400 | 1392 | 1392 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7271889 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 357 | TotalRevenueColumn |
| Exclusion | $357 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7272246 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7271889 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $357 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3578177 | Total |
| Program Services | 3041450 | ProgramServices |
| Management And General | 536727 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 819537 | Total |
| Program Services | 696606 | ProgramServices |
| Management And General | 122931 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222680 | Total |
| Program Services | 189278 | ProgramServices |
| Management And General | 33402 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4952 | Total |
| Management And General | 4952 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 555216 | Total |
| Program Services | 471934 | ProgramServices |
| Management And General | 83282 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10408 | Total |
| Program Services | 8847 | ProgramServices |
| Management And General | 1561 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94182 | Total |
| Program Services | 80055 | ProgramServices |
| Management And General | 14127 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2843 | Total |
| Program Services | 2417 | ProgramServices |
| Management And General | 426 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63171 | Total |
| Program Services | 53695 | ProgramServices |
| Management And General | 9476 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199376 | Total |
| Program Services | 169470 | ProgramServices |
| Management And General | 29906 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10318 | Total |
| Program Services | 8770 | ProgramServices |
| Management And General | 1548 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES AND DRUGS | 774967 | 658722 | 116245 |
| QAAP ASSESSMENTS | 733997 | 733997 | |
| REPAIRS & MAINTENANCE | 34668 | 29468 | 5200 |
| EQUIPMENT RENTAL | 17101 | 14536 | 2565 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168081 | Total |
| Program Services | 143974 | ProgramServices |
| Management And General | 24107 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7289674 | Total |
| Program Services | 6303219 | ProgramServices |
| Management And General | 986455 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 679189 | BOY |
| EOY | 84726 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 454921 | BOY |
| EOY | 484463 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8651 | BOY |
| EOY | 6329 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 13478525 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2925348 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3467307 | BOY |
| EOY | 10553177 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2761719 | BOY |
| EOY | 3264869 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7371787 | BOY |
| EOY | 14393564 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 398725 | BOY |
| EOY | 1200009 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2287635 | BOY |
| EOY | 8594122 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164216 | BOY |
| EOY | 95650 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2850576 | BOY |
| EOY | 9889781 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4521211 | BOY |
| EOY | 4503783 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4521211 | BOY |
| EOY | 4503783 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7371787 | BOY |
| EOY | 14393564 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -17428 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2924 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 42 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 60 | CurrentTaxYearMinus2Years |
| Total | 3026 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7999044 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8187759 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8028555 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7410997 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7271889 | CurrentTaxYear |
| Total | 38898244 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 8001968 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8187801 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8028615 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7410997 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7271889 | CurrentTaxYear |
| Total | 38901270 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 38901270 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1701 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 855 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 787 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4769 | CurrentTaxYearMinus1Year |
| Current Tax Year | 357 | CurrentTaxYear |
| Total | 8469 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1701 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 855 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 787 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4769 | CurrentTaxYearMinus1Year |
| Current Tax Year | 357 | CurrentTaxYear |
| Total | 8469 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 8003669 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8188656 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8029402 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7415766 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7272246 | CurrentTaxYear |
| Total | 38909739 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99980 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99970 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00020 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00030 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 162800 | OtherCostOrOtherBasis |
| Book Value | 162800 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4059533 | OtherCostOrOtherBasis |
| Depreciation | 2621033 | Depreciation |
| Book Value | 1438500 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 491487 | OtherCostOrOtherBasis |
| Depreciation | 304315 | Depreciation |
| Book Value | 187172 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8764705 | OtherCostOrOtherBasis |
| Book Value | 8764705 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10553177 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BOND ISSUE COSTS | 149658 |
| DUE FROM RELATED PARTIES | 3115211 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3264869 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | COST REPORT SETTLEMENT PAYABLE | Description |
| Amount | $95,650 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 95650 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 7264878 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -7368 | OtherRevenues |
| Revenue Not Rptd F990 | -7368 | RevenueNotRptdF990 |
| Revenue Subtotal | 7272246 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7272246 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7282306 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7282306 | ExpensesSubtotal |
| Other Expenses Not Included | 7368 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 7368 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7289674 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | LAKELAND REGIONAL HEALTH SYSTEM, INC. AND ITS WHOLLY OWNED SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES EXCEPT FOR LAKELAND HEALTH ENTERPRISES, INC. AND SUBSIDIARIES, WHICH ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. INCOME TAX EXPENSE FOR THE FOR-PROFIT CORPORATIONS IS NOT SIGNIFICANT AND HAS BEEN INCLUDED IN OPERATING EXPENSES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY LAKELAND AND RECOGNIZE A TAX LIABILITY IF LAKELAND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY LAKELAND AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. LAKELAND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2010. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS -7,368. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 7,368. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOREN HAMEL MD | ||||||||||||||
| PRESIDENT & CEO | 0 | 511565 | 0 | 105000 | 0 | 54634 | 0 | 46402 | 0 | 4235 | 0 | 721836 | 0 | 0 |
| LAURENCE HABENICHT MD | ||||||||||||||
| DIRECTOR | 0 | 318557 | 0 | 0 | 0 | 0 | 0 | 12650 | 0 | 10297 | 0 | 341504 | 0 | 0 |
| EWANAH JOHNSON MD | ||||||||||||||
| DIRECTOR | 0 | 241898 | 0 | 0 | 0 | 0 | 0 | 6795 | 0 | 27709 | 0 | 276402 | 0 | 0 |
| KEITH VANOOSTERHOUT MD | ||||||||||||||
| DIRECTOR | 0 | 206885 | 0 | 0 | 0 | 0 | 0 | 6207 | 0 | 16225 | 0 | 229317 | 0 | 0 |
| TIMOTHY CALHOUN | ||||||||||||||
| VP - FINANCE & CFO | 0 | 288408 | 0 | 70103 | 0 | 9151 | 0 | 32170 | 0 | 3838 | 0 | 403670 | 0 | 0 |
| EILEEN WILLITS | ||||||||||||||
| VP - PATIENT CARE SERVICES | 0 | 222836 | 0 | 39385 | 0 | 14922 | 0 | 27525 | 0 | 2919 | 0 | 307587 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | LAKELAND MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE PLAN ARE: LOREN HAMEL, MD; TIMOTHY CALHOUN; DENNIS MACK; EILEEN WILLITS | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL AUTHORITY OF THE CITY OF ST JOSEPH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 383151499 | IssuerEIN |
| CUSIP Number | NONEAVIAL | CUSIPNumber |
| Date Issued | 2012-09-06 | DateIssued |
| Issue Price | 8500000 | IssuePrice |
| Description Of Purpose | NEW FACILITY CONSTRUCTION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | 8500000 | TotalProceeds |
| Issuance Costs From Proceeds | 105875 | IssuanceCostsFromProceeds |
| Capital Expenditures | 8394125 | CapitalExpenditures |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 1 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 0 | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BOND ISSUE A: | Identifier |
| Explanation | THE $8.5 MILLION BOND ISSUE WAS A DIRECT PURCHASE BOND BY JPMORGAN CHASE. BOND PROCEEDS WERE DRAWN DURING CONSTRUCTION PERIOD TO BUILD A NEW FACILITY. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE 990 HAS BEEN POSTED ON THE BOARD PORTAL FOR REVIEW PRIOR TO FILING. THE BOARD PORTAL IS AVAILABLE TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN. |
| THE CEO AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEO'S COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2013. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN THE AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKELAND REGIONAL HEALTH SYSTEM INC | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382609624 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(C)(3) | LINE 11B, II | N/A | 0 | |
| LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382156872 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(C)(3) | LINE 3 | 1 | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND SPECIALITY HOSPITAL AT BERRIEN CENTER | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383452303 | LONGTERM HEALTHCARE/HEALING SERVICES | MI | 501(C)(3) | LINE 3 | 1 | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382539929 | PROMOTE AND ASSIST IN PROVIDING HEALTH CARE | MI | 501(C)(3) | LINE 7 | 1 | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND HEALTH FOUNDATION NILES | |||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383130558 | PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGAN | MI | 501(C)(3) | LINE 7 | 1 | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND COMMUNITY HOSPITAL - WATERVLIET | |||||||||||
| 400 MEDICAL PARK DRIVE | WATERVLIET | MI | 49098 | 381368745 | TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCARE | MI | 501(C)(3) | LINE 9 | 1 | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| HOSPICE AT HOME INC | |||||||||||
| 4025 HEALTH PARK LANE | ST JOSEPH | MI | 49085 | 382416086 | TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILL | MI | 501(C)(3) | LINE 7 | 1 | LAKELAND REGIONAL HEALTH SYSTEM INC | |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| VAN'S MEDICAL EQUIPMENT OF LAKELAND LLC | |||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 261497708 | MEDICAL EQUIPMENT | MI | N/A |
| CLIFFSIDE COMPANY LLC | |||||||
| 910 S WASHINGTON AVENUE | ROYAL OAK | MI | 48067 | 383306320 | ASSISTED LIVING | MI | N/A |
| LAKELINE ASSOCIATES LLC | |||||||
| 910 S WASHINGTON AVENUE | ROYAL OAK | MI | 48067 | 383306318 | PROPERTY MANAGEMENT/RENTAL | MI | N/A |
| LIBERTY DIALYSIS LAKELAND LLC | |||||||
| 7650 SE 27TH STREET SUITE 200 | MERCER ISLAND | WA | 98040 | 272099855 | MEDICAL SERVICES | WA | N/A |
| LDBH LLC | |||||||
| 7650 SE 27TH STREET SUITE 200 | MERCER ISLAND | WA | 98040 | 451745643 | MEDICAL SERVICES | WA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|
| LAKELAND HEALTH ENTERPRISES INC | ||||||||||
| 31 NORTH ST JOSEPH AVENUE | NILES | MI | 49120 | 382669798 | ACCOUNTING AND BILLING | MI | LAKELAND REGIONAL HEALTH SYSTEM INC | C | 1 | |
| PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 382929090 | PHARMACEUTICALS | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| LAKELAND MEDICAL PRACTICES | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 270381199 | MEDICAL ADMINISTRATIVE SERVICES | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272589359 | PHYSICIAN OFFICE | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| FOUR FLAGS PROPERTIES INC | ||||||||||
| 122 GRANT STREET | NILES | MI | 49120 | 364501639 | PROPERTY MANAGEMENT/RENTAL | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| LAKELAND HEALTH VENTURES INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272313790 | HOLDING COMPANY | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| LAKELAND PHYSICIAN CARE NETWORK | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 208513031 | MEDICAL SERVICES | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| LAKELAND PERSONAL CARE SERVICES INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 272990797 | HEALTH CARE SERVICES | MI | LAKELAND HEALTH ENTERPRISES INC | C | 1 | |
| LAKELAND CARE INC | ||||||||||
| 1234 NAPIER AVENUE | ST JOSEPH | MI | 49085 | 383225306 | CONTRACT NEGOTIATION | MI | C | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | O | TransactionType |
| Amount Involved | 755973 | AmountInvolved |
| Method Of Amt Determination | ALLOCATION OF EXPENSE | MethodOfAmtDetermination |
Comments