MCLAREN CARO REGION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MCLAREN CARO REGION (EIN 38-3426063)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-04
- IRS object ID
- 201413089349300416
- Schema version
- 2013v3.1
- 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) |
|---|---|---|
| Return | 2014-11-04T07:23:51-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382475073 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDERSON TUCKEY BERNHARDT & DORAN PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 E FRANK STREET | AddressLine1 |
| City | CARO | City |
| State | MI | State |
| ZIP Code | 48723 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383426063 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARO COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARO | BusinessNameControlTxt |
| Phone | 9896733141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 N HOOPER PO BOX 435 | AddressLine1 |
| City | CARO | City |
| State | MI | State |
| ZIP Code | 48723 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARC AUGSBURGER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9896733141 | PhoneNum |
| Signature | 2014-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TIMOTHY D FRANZEL | PreparerPersonNm |
| PTIN | P00851336 | PTIN |
| Phone | 9896733137 | PhoneNum |
| Preparation | 2014-10-31 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARC AUGSBURGER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 N HOOPER PO BOX 435 | AddressLine1 |
| City | CARO | City |
| State | MI | State |
| ZIP Code | 48723 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,631,897 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CCH-MI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | CARO COMMUNITY HOSPITAL, A COMMUNITY-MINDED HEALTHCARE SYSTEM, IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 162 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $116,290 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,660 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,472,060 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,453,508 | CYProgramServiceRevenueAmt |
| PY Investment Income | $37,037 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,936 | CYInvestmentIncomeAmt |
| PY Other Revenue | $137,994 | PYOtherRevenueAmt |
| CY Other Revenue | $47,967 | CYOtherRevenueAmt |
| PY Total Revenue | $11,763,381 | PYTotalRevenueAmt |
| CY Total Revenue | $11,508,071 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,690,544 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,054,506 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,731,023 | PYOtherExpensesAmt |
| CY Other Expenses | $4,112,382 | CYOtherExpensesAmt |
| PY Total Expenses | $11,421,567 | PYTotalExpensesAmt |
| CY Total Expenses | $11,166,888 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $341,814 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $341,183 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,327,985 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,953,207 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,033,856 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,248,308 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,294,129 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,704,899 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CARO COMMUNITY HOSPITAL, A COMMUNITY-MINDED HEALTHCARE SYSTEM, IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,996,235 | ExpenseAmt |
| Desc | PROVISION OF NEEDED MEDICAL SERVICES TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $7,996,235 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 162 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD SREBINSKI CFO | PersonNm |
| Phone | 9896733141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 N HOOPER ST | AddressLine1 |
| City | CARO | City |
| State | MI | State |
| ZIP Code | 48723 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| DALE PERZ | ||||||||
| VICE CHAIRMA | 20.00 | Yes (X) | Yes (X) | $0 | $57,638 | $0 | ||
| RUBY REID | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $3,298 | $0 | |||
| DAN BRISTOL | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DR ALFONSO FERREIRA | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LYNN LAETHEM | ||||||||
| SECRETARY/TR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RAYMOND BATES | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RICK FULTON | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARC AUGSBURGER | ||||||||
| PRESIDENT AN | 27.00 | Yes (X) | $114,627 | $0 | $35,465 | |||
| SUE MORRIS | ||||||||
| RISK/COMPLIA | 40.00 | $139,693 | $0 | $17,450 | Yes (X) | |||
| RONALD SREBINSKI | ||||||||
| CFO | 40.00 | $107,207 | $0 | $14,150 | Yes (X) | |||
| WILLIAM MILLER | ||||||||
| FORMER PRES. | 17.00 | $65,766 | $0 | $18,093 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $427,293 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $60,936 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $85,158 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HOSPITAL MD | |||||
| 200 W PARK DRIVE STE 325 | PEACHTREE CITY | GA | 30269 | E.R. PHYSICIANS | $696,000 |
| WESTERN HEALTHCARE LLC | |||||
| PO BOX 203152 | DALLAS | TX | 753203152 | DOCTORS | $161,658 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $3,660 | AllOtherContributionsAmt |
| Total Contributions | $3,660 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Total Revenue Column | $11,453,508 | TotalRevenueColumnAmt |
| Exclusion | $11,453,508 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,453,508 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,936 | TotalRevenueColumnAmt |
| Exclusion | $2,936 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $83,230 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $123,826 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$40,596 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$40,596 | TotalRevenueColumnAmt |
| Exclusion | -$40,596 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $7,931 | GrossSalesOfInventoryAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,931 | TotalRevenueColumnAmt |
| Exclusion | $7,931 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|
| OTHER | $67,116 | $67,116 |
| CAFETERIA | $10,461 | $10,461 |
| HPSA PAYMENTS | $3,055 | $3,055 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $80,632 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,508,071 | TotalRevenueColumnAmt |
| Exclusion | $11,504,411 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,707,456 | TotalAmt |
| Program Services | $3,136,444 | ProgramServicesAmt |
| Management And General | $1,571,012 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,227 | TotalAmt |
| Program Services | $169,227 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,827,709 | TotalAmt |
| Program Services | $1,217,803 | ProgramServicesAmt |
| Management And General | $609,906 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,114 | TotalAmt |
| Program Services | $230,011 | ProgramServicesAmt |
| Management And General | $120,103 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,320 | TotalAmt |
| Management And General | $36,320 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,500 | TotalAmt |
| Management And General | $38,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,162,566 | TotalAmt |
| Program Services | $2,635,348 | ProgramServicesAmt |
| Management And General | $527,218 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,227 | TotalAmt |
| Management And General | $45,227 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,587 | TotalAmt |
| Program Services | $28,752 | ProgramServicesAmt |
| Management And General | $27,835 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,794 | TotalAmt |
| Program Services | $106,794 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $561,420 | TotalAmt |
| Program Services | $366,888 | ProgramServicesAmt |
| Management And General | $194,532 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,968 | TotalAmt |
| Program Services | $104,968 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,166,888 | TotalAmt |
| Program Services | $7,996,235 | ProgramServicesAmt |
| Management And General | $3,170,653 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,384,529 | BOYAmt |
| EOY | $1,377,295 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $804,695 | BOYAmt |
| EOY | $704,634 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,688 | BOYAmt |
| EOY | $327,275 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,426 | BOYAmt |
| EOY | $62,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,498,070 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,562,213 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,290,704 | BOYAmt |
| EOY | $4,935,857 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $526,943 | BOYAmt |
| EOY | $545,477 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,327,985 | BOYAmt |
| EOY | $7,953,207 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,770 | BOYAmt |
| EOY | $569,079 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $386,704 | BOYAmt |
| EOY | $257,802 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,643,908 | BOYAmt |
| EOY | $1,881,017 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,566,474 | BOYAmt |
| EOY | $1,540,410 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,033,856 | BOYAmt |
| EOY | $4,248,308 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,767,186 | BOYAmt |
| EOY | $3,108,369 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $526,943 | BOYAmt |
| EOY | $596,530 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,294,129 | BOYAmt |
| EOY | $3,704,899 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,327,985 | BOYAmt |
| EOY | $7,953,207 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $341,183 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $69,587 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $133,521 | OtherCostOrOtherBasisAmt |
| Book Value | $133,521 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,860,544 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,746,309 | DepreciationAmt |
| Book Value | $3,114,235 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,112 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,559 | DepreciationAmt |
| Book Value | $553 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,491,893 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,804,345 | DepreciationAmt |
| Book Value | $1,687,548 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,935,857 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTEREST IN NET ASSETS OF FOUNDATION | Desc |
| Book Value | $545,477 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $545,477 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD-PARTY SETTLEMENTS | $882,097 |
| ACCRUED LIABILITIES | $658,313 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,540,410 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,334 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $60,334 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,817,052 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $894,687 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $922,365 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,877,386 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $894,687 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $982,699 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08800 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,029 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $100 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $186,929 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01670 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,029 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $100 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $186,929 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,064,415 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $894,787 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,169,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10470 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 246 | PersonsServedCnt |
| Total Community Benefit Expns | $24,081 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,255 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 246 | PersonsServedCnt |
| Total Community Benefit Expns | $24,081 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,255 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $528,411 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $187,029 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,742,989 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,742,989 | CostOfCareReimbursedByMedcrAmt |
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| 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 | CARO COMMUNITY HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 N HOOPER ST PO BOX 43 | AddressLine1 |
| City | CARO | City |
| State | MI | State |
| ZIP Code | 48723 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARO COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CCH-MI.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| FAP Actions On Nonpayment | false | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CARO COMMUNITY HOSPITAL - PART V, LINE 3 | PARTICIPANTS INCLUDED CCH BOARD MEMBERS, CCH STAFF INCLUDING CLINICAL AND ADMINISTRATIVE PERSONS, THE OWNER OF A LOCAL FREE HEALTH CLINIC, TUSCOLA COUNTY HEALTH DEPT, MICHIGAN STATE UNIVERSITY EXTENSION, TUSCOLA INTERMEDIATE SCHOOL DISTRICT, GREAT START COLLABORATIVE, HOSPICE AND HOME HEALTH CARE EMPLOYEES, A LOCAL MEDICAL SUPPLY COMPANY, LOCAL MRI SERVICE, A LOCAL MINISTER, SENIOR CITIZENS, AND COMMUNITY MEMBERS. |
| FACILITY 1, CARO COMMUNITY HOSPITAL - PART V, LINE 7 | SURVEY WAS COMPLETED IN NOVEMBER 2013 |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | THE HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CHARITY SERVICES. |
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | THE ANNUAL COMMUNITY BENEFIT AMOUNT RELATES TO THE VALUE OF SALARIES AND FRINGE BENEFITS OF THE HOSPITAL HEALTH SERVICES DEPARTMENT WHICH PROVIDES SPECIALITY PHYSICIANS TO THE CARO COMMUNITY BY RENTING CLINIC SPACE AND PROVIDING RECEPTIONIST SERVICES TO THE PATIENTS OF TUSCOLA COUNTY AREA WHO WOULD HAVE TO DRIVE 35 TO 50 MILES OR EVEN TAKE THE DAY OFF FROM WORK TO RECEIVE ROUTINE SPECIALIST PHYSICIAN SERVICES. 151,817. ALSO, THE COMMUNITY BENEFIT COST ASSOCIATED WITH PARTICIPATING IN BLOOD DRIVES, DOING SPORTS PHYSICALS, COMMUNITY CRAFT PROGRAMS, SENIOR FAIRS, HEALTH EVENTS AT THE FAIR, HOSPITAL AND AROUND THE CARO AREA IS 9,000. TOTAL COMMUNITY BENEFIT VALUE IS 160,817. |
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | N/A |
| PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | N/A |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO INDIVIDUALS THAT MAY QUALIFY FOR CHARITY CARE WAS CALCULATED BASED UPON THE AMOUNT OF SELF PAY EMERGENCY ROOM PATIENT CHARGES TIMES 20%, WHICH IS THE AMOUNT THAT PATIENTS WOULD QUALIFY FOR A DISCOUNT. THE BALANCE OF THE PATIENT ACCOUNTS WOULD THEN BE SUBJECTED TO CHARITY CARE GUIDELINES OF EARNINGS OF 250% OR LESS OF THE FEDERAL POVERTY GUIDELINES. 187,029. THE COSTING METHOODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN LINES 7 (A)-(D) IS BASED ON THE COST-TO-CHARGE RATIOS. LINES 7(E)-(I) IS BASED ON ACTUAL COST. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED ATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED UPON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. THE HOSPITAL COST TO CHARGE RATIO IS UTILIZED IN DETERMINING THE COST OF BAD DEBTS. BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 THAT IS REMOVED FOR PURPOSES OF SCHEDULE H LINE 7 COLUMN F IS 902,341. COST OF THE NET BAD DEBT EXPENSE IS 528,411. THEREFORE THE COST IS AT 58.56%. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | IF THE PATIENT IS NOT ABLE TO MAKE PAYMENT ARRANGEMENTS, THE STAFF WILL VERBALLY DETERMINE IF THE PATIENT IS POTENTIALLY ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL CHARITY CARE POLICY. PATIENTS WHO APPEAR TO MEET THE CARO COMMUNITY HOSPITAL CRITERIA ARE REFERRED TO THE SOCIAL WORKER FOR FURTHER REVIEW IN ACCORDANCE WITH THE HOSPITAL CHARITY CARE POLICY. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | ORGANIZATION COMMUNICATED WITH STATE AND LOCAL AGENCIES TO DETERMINE THE HEALTHCARE NEEDS OF THE COMMUNITY. EXAMPLES OF SERVICES PROVIDED BASED ON COMMUNITY NEEDS ARE IMMUNIZATIONS, VACCINES, SPOTS PHYSICALS, SENIOR AND HEALTH FAIRS, FIRST AID BOOTH, AND DIABETIC CLASSES. CARO COMMUNITY HOSPITAL HAS CURRENTLY JOINED THE MICHIGAN RURAL HEALTH GROUP WHO WILL CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE HOSPITAL IN 2013. THE HEALTH NEEDS ASSESSMENT WAS DONE NOVEMBER OF 2013 AND IS POSTED ON CCH PUBLIC WEBSITE. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | EVERY UNINSURED PATIENT THAT IS AN INPATIENT, OUTPATIENT, SURGICAL, OBSERVATION, OR INCURS MORE THAN 5,000 IN MEDICAL EXPENSES, RECEIVES A CHARITY CARE PACKAGE. THE PACKAGE INCLUDES A CHARITY CARE AND MEDICAID APPLICATION AND A HUMAN SERVICES REFERRAL FORM. ALL OTHER NON-INSURED PATIENTS MAY REQUEST A CHARITY CARE APPLICATION AT ANY TIME. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | ORGANIZATION IS LOCATED IN TUSCOLA COUNTY WHICH HAS A POPULATION OF APPROX. 56,000, CARO HAS A POPULATION OF APPROX 4,200. TUSCOLA COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES. THE UNEMPLOYMENT RATE IN TUSCOLA COUNTY IS HIGH BECAUSE OF THE LOSS OF MANY SMALL AUTOMOTIVE RELATED JOBS AND IS AT OR ABOVE THE STATE OF MICHIGAN'S UNEMPLOYMENT RATE. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | ORGANIZATION PROVIDES SPECIAL CLINICS IN CARO SO PATIENTS DO NOT HAVE TO COMMUTE. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | N/A |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | MICHIGAN |
| ADDITIONAL INFORMATION | ALL PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE OF AN EXTENDED PAYMENT PLAN DEPENDING ON THE DOLLAR AMOUNT OF THE BILL OWED. IN 2012 EMERGENT PATIENTS WITHOUT ANY TYPE OF COVERAGE WERE ALSO EXTENDED A 20% DISCOUNT PLUS OFFERED AN EXTENDED PAYMENT PLAN IF NEEDED. THE DISCOUNT PLAN ESTABLISHED IN 2012 WAS BASED ON THE AVERAGE TOTAL COMMERCIAL COVERAGE AND ONE GOVERNMENT PLAN WHICH WAS WORKERS COMPENSATION AND THE AVERAGE CAME TO 20% DISCOUNTED. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt |
|---|---|---|---|---|---|---|
| MARC AUGSBURGER | ||||||
| PRESIDENT AND CEO | $114,627 | $35,465 | $114,627 | $35,465 | ||
| SUE MORRIS | ||||||
| RISK/COMPLIANCE | $139,693 | $157,143 | $17,450 | |||
| WILLIAM MILLER | ||||||
| FORMER PRES. & CEO | $65,766 | $83,859 | $18,093 | |||
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DALE PERZ - PERZPECTIVES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $57,638 | TransactionAmt |
| Transaction | MARKETING SERVICES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | EACH BOARD MEMBER WILL RECEIVE A COMPLETE COPY OF THE RETURN. THE CEO AND CFO WILL REVIEW THE RETURN DURING THE NOVEMBER MEETING OF THE BOARD OF TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS MONITORED THROUGH DISCUSSION WITH THE CEO AND EACH BOARD MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD UTILIZES THE MICHIGAN HEALTH AND HOSPITAL ANNUAL SURVEY TO DETERMINE THE COMPENSATION LEVEL FOR THE CEO. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC. |
| FORM 990, PART IX, LINE 11G | DUES AND SUBSCRIPTIONS 114,003 0 0 SUPPLIES 891,278 231,071 0 PURCHASED SERVICES 370,718 278,273 0 STATE OF MICH QAAP TAX 269,473 0 0 UTILITIES 258,439 0 0 REPAIRS AND MAINTENANCE 303,760 17,874 0 OTHER 427,677 0 0 |
| FORM 990, PART XI, LINE 9 | NET CHANGE IN CCH ENDOWMENT FOUNDATION 69,587 CCH FOUNDATION FOR 2013 |
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CCH HEALTH CARE ALLIANCE | ||||||||||
| 401 N HOOPER STREET | CARO | MI | 48473 | 383426058 | PARENT | MI | 501C | 3 | N/A | false |
| CCH ENDOWMENT FOUNDATION | ||||||||||
| 401 N HOOPER STREET | CARO | MI | 48473 | 382422995 | FOUNDATION | MI | 501C | 3 | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments