MCKENIZE MEMORIAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MCKENIZE MEMORIAL HOSPITAL (EIN 38-1738615)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-05-14
- IRS object ID
- 201421349349303502
- Schema version
- 2012v2.3
- 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 D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T10:54:57-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRINING & NARTKER PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 47 AUSTIN STREET PO BOX 348 | AddressLine1 |
| City | SANDUSKY | City |
| State | MI | State |
| ZIP Code | 484710348 | 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 | 381738615 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MCKE | NameControl |
| Phone | 8106486162 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1 |
| City | SANDUSKY | City |
| State | MI | State |
| ZIP Code | 48471 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMY RUEDISUELI | Name |
| Title | VP OF FINANCE | Title |
| Phone | 8106486162 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOSEPH NARTKER | Name |
| Phone | 8106484931 | Phone |
| Date Prepared | 2014-05-14 | DatePrepared |
| 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 | MCKENZIE HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEVE BARNETT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELEWARE STREET | AddressLine1 |
| City | SANDUSKY | City |
| State | MI | State |
| ZIP Code | 48471 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19597559 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MCKENZIEHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1961 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | FOUNDED AS A COMMUNITY HOSPITAL, MCKENIZE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT, COMPASSIONATE AND ESSENTIAL HEALTHCARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 20 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 250 | TotalNbrEmployees |
| Total Nbr Volunteers | 40 | TotalNbrVolunteers |
| Total Gross UBI | 76974 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -13183 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 225878 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 54535 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20613821 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 19312035 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 28514 | InvestmentIncomePriorYear |
| Investment Income Current Year | 84310 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 77700 | OtherRevenuePriorYear |
| Other Revenue Current Year | 99270 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20945913 | TotalRevenuePriorYear |
| Total Revenue Current Year | 19550150 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10155361 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10594857 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9906892 | OtherExpensePriorYear |
| Other Expenses Current Year | 8441308 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 20062253 | TotalExpensesPriorYear |
| Total Expenses Current Year | 19036165 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 883660 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 513985 | RevenuesLessExpensesCY |
| Total Assets BOY | 10469675 | TotalAssetsBOY |
| Total Assets EOY | 9808280 | TotalAssetsEOY |
| Total Liabilities BOY | 6536498 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5361118 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3933177 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4447162 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | FOUNDED AS A COMMUNITY HOSPITAL, MCKENIZE MEMORIAL HOSPITAL EXISTS TO PROVIDE EXCELLENT, COMPASSIONATE AND ESSENTIAL HEALTHCARE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | true | SignificantChange |
| Expense | 19036165 | Expense |
| Revenue | 19550150 | Revenue |
| Description | PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SANILAC COUNTY. FISCAL YEAR REGISTRATIONS ARE: INPATIENT = 390; OUTPATIENT = 25,573 EMERGENCY ROOM = 6,032; AND AMBULANCE = 1,809. | Description |
| Total Program Service Expense | 19036165 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 54 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 250 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 20 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | AMY RUEDISUELI | NamePerson |
| Telephone Number | 8106486162 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 394 LORAINE STREET | AddressLine1 |
| City | SANDUSKY | City |
| State | MI | State |
| ZIP Code | 48471 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per WeekAverageHoursPerWeek | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| DR WILLIAM STARBIRD | |||||||||
| MARLETTE PHY | 40.00 | X | 0 | 277174 | 11855 | ||||
| DAN BABCOCK | |||||||||
| MARLETTE CEO | 40.00 | X | 0 | 184286 | 1781 | ||||
| STEVE BARNETT | |||||||||
| MCKENZIE CEO | X | 183289 | 0 | 21360 | 40.00 | X | |||
| MARK ENGLISH | |||||||||
| CHIEF OF STA | X | 159146 | 0 | 24526 | 40.00 | X | |||
| LES PHILLIPS | |||||||||
| CHAIRMAN | X | 0 | 0 | 0 | X | ||||
| ROGER LODING | |||||||||
| VICE CHAIRPE | X | 0 | 0 | 0 | X | ||||
| CHRIS CLARK | |||||||||
| SECRETARY | X | 0 | 0 | 0 | X | ||||
| AL STOUTENBURG | |||||||||
| TREASURER | X | 0 | 0 | 0 | X | ||||
| JUDITH FERGUSON | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| LARRY MITCHELL | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| RALPH DESHETSKY | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| MICHAEL DREYER | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| DR ROBERT HASSLER | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| GLEN KAMPMAN | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| DORIS HUNTOON | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| SUE COOK | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| MEREDITH LYONS | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| JOAN NAGELKIRK | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| SCOTT ORR | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| DAVE TUBBS | |||||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||||
| DR ALFREDO DOMINGO | |||||||||
| PHYSICIAN | 387140 | 0 | 0 | 40.00 | X | ||||
| DR MICHAEL MERKLER | |||||||||
| PHYSICIAN | 216881 | 0 | 22339 | 40.00 | X | ||||
| DR JAMES SAMS | |||||||||
| PHYSICIAN | 195521 | 0 | 13157 | 40.00 | X | ||||
| DR MATTHEW GORMLEY | |||||||||
| PHYSICIAN | 189486 | 0 | 23103 | 40.00 | X | ||||
| DR MELANIE KRAMER | |||||||||
| PHYSICIAN | 225880 | 0 | 18351 | 40.00 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1557343 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 461460 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 136472 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MICHIGAN EMERGENCY PHYSICIANS LLP | |||||
| PO BOX 793 | TRAVERSE CITY | MI | 49685 | ER COVERAGE | 1335220 |
| CPSI | |||||
| 6600 WALL STREET | MOBILE | AL | 36695 | COMPUTER TECH | 139898 |
| PHYSICIAN HEALTHCARE NETWORK | |||||
| 3050 COMMERCE DR | FORT GRATIOT | MI | 48059 | SURGICAL COVERA | 129313 |
| COVENANT HEALTHCARE | |||||
| 1447 NORTH HARRISON | SAGINAW | MI | 48602 | REFERENCE LAB | 119652 |
| TOSHIBA AMERICAN MEDICAL | |||||
| PO BOX 91605 | TUSTIN | CA | 92780 | CT MAINT | 105417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| All Other Contributions | 54535 | AllOtherContributions |
| Total Contributions | 54535 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| INPATIENT & OUTPATIENT REVENU | 31080534 | 31080534 |
| PHYSICIAN REVENUE | 2600174 | 2600174 |
| ALL OTHER PROGRAM SERVICE REV | 972462 | 972462 |
| RURAL HEALTH REVENUE | 572569 | 572569 |
| BAD DEBT & CHARITY CARE | -1267736 | -1267736 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -14645968 | TotalRevenueColumn |
| Related Or Exempt Function Income | -14645968 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 19312035 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 84310 | TotalRevenueColumn |
| Related Or Exempt Function Income | 84310 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 76974 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 76974 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 76974 | TotalRevenueColumn |
| Unrelated Business Revenue | 76974 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 72522 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 47409 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25113 | TotalRevenueColumn |
| Exclusion | $25,113 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SALE OF ASSET | Description |
| Total Revenue Column | -2817 | TotalRevenueColumn |
| Related Or Exempt Function Income | -2817 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -2817 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19550150 | TotalRevenueColumn |
| Related Or Exempt Function Income | 19393528 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 76974 | UnrelatedBusinessRevenue |
| Exclusion | $25,113 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213215 | Total |
| Management And General | 213215 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8367737 | Total |
| Program Services | 6417787 | ProgramServices |
| Management And General | 1949950 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 232404 | Total |
| Program Services | 176740 | ProgramServices |
| Management And General | 55664 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1201639 | Total |
| Program Services | 886381 | ProgramServices |
| Management And General | 315258 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 579862 | Total |
| Program Services | 441903 | ProgramServices |
| Management And General | 137959 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166405 | Total |
| Management And General | 166405 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29900 | Total |
| Management And General | 29900 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3145503 | Total |
| Program Services | 2779330 | ProgramServices |
| Management And General | 366173 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72154 | Total |
| Program Services | 15057 | ProgramServices |
| Management And General | 57097 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1473232 | Total |
| Program Services | 1292682 | ProgramServices |
| Management And General | 180550 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 264364 | Total |
| Program Services | 31178 | ProgramServices |
| Management And General | 233186 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 443607 | Total |
| Program Services | 436520 | ProgramServices |
| Management And General | 7087 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120183 | Total |
| Program Services | 86026 | ProgramServices |
| Management And General | 34157 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25208 | Total |
| Program Services | 16481 | ProgramServices |
| Management And General | 8727 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27433 | Total |
| Program Services | 27433 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 749086 | Total |
| Program Services | 514758 | ProgramServices |
| Management And General | 234328 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 183871 | Total |
| Program Services | 167372 | ProgramServices |
| Management And General | 16499 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DRUGS | 542665 | 542665 | |
| TAXES & LICENSES | 404378 | 44638 | 359740 |
| LEASE, RENT & MISC | 301537 | 270106 | 31431 |
| OTHER EXPENSES | 262297 | 79255 | 183042 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229485 | Total |
| Program Services | 216473 | ProgramServices |
| Management And General | 13012 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19036165 | Total |
| Program Services | 14442785 | ProgramServices |
| Management And General | 4593380 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45884 | BOY |
| EOY | 103607 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1973814 | BOY |
| EOY | 1857145 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2814277 | BOY |
| EOY | 2246210 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 463141 | BOY |
| EOY | 462844 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200094 | BOY |
| EOY | 224235 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 15351319 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 10586944 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4822601 | BOY |
| EOY | 4764375 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 149864 | BOY |
| EOY | 149864 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10469675 | BOY |
| EOY | 9808280 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2598992 | BOY |
| EOY | 2561324 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 258639 | BOY |
| EOY | 137332 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2434891 | BOY |
| EOY | 2028420 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 619355 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 624621 | BOY |
| EOY | 634042 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6536498 | BOY |
| EOY | 5361118 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3829263 | BOY |
| EOY | 4382077 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 103914 | BOY |
| EOY | 65085 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3933177 | BOY |
| EOY | 4447162 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10469675 | BOY |
| EOY | 9808280 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 513985 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | true | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 160652 | OtherCostOrOtherBasis |
| Book Value | 160652 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7358209 | OtherCostOrOtherBasis |
| Depreciation | 4549148 | Depreciation |
| Book Value | 2809061 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 284554 | OtherCostOrOtherBasis |
| Depreciation | 238433 | Depreciation |
| Book Value | 46121 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7546904 | OtherCostOrOtherBasis |
| Depreciation | 5799363 | Depreciation |
| Book Value | 1747541 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1000 | OtherCostOrOtherBasis |
| Book Value | 1000 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4764375 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (13 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| EVERBANK - DIG MAM | $166,651 |
| INSIGHT - ULTRASOUND | $87,169 |
| KINGSBRIDGE - DIGITIZER & CR | $70,737 |
| KINGSBRIDGE - TELEMETRY | $69,208 |
| TRI COUNTY - COMPUTER SERVERS | $59,541 |
| NORTHSTAR - AMBULANCE | $52,325 |
| GE - C - ARM & BONE DENSITY | $44,307 |
| TRI - COUNTY - AUTOCLAVE | $31,811 |
| ESB - AMBULANCE | $20,675 |
| ESB - 2013 FORD | $17,156 |
| KINGSBRIDE - STERILIZER | $14,462 |
| CAHSE - LINE OF CREDIT | |
| ESB - X-RAY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 634042 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 19386205 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 19386205 | RevenueSubtotal |
| Other Revenues Not Included | 163945 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 163945 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 19550150 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 19036165 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 19036165 | ExpensesSubtotal |
| Total Expenses Per Form990 | 19036165 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| REVENUE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 4B | CONTRIBUTION FOR PP&E 35,232 INTEREST INCOME 84,250 CONTRIBUTIONS 43,737 INTEREST FROM TEMPORARY RESTRICITIONS 726 |
| EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 4B | ROUNDING 6 BOOK / TAX DEPRECIATION DIFFERENCE 749,086 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed States | MI | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | BENEFIT RAFFLE | NameOfEvent1 |
| Gross Receipts Event1 | 43439 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 43439 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 9000 | CashPrizesEvent1 |
| Rent Facility Costs Event1 | 500 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 9237 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 450 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 4457 | OtherDirectExpensesEvent1 |
| Name Of Event2 | HOSP AUXILARY | NameOfEvent2 |
| Gross Receipts Event2 | 29083 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 29083 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 23765 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 72522 | GrossReceiptsTotal |
| Gross Revenue Total Events | 72522 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 9000 | CashPrizesTotalEvents |
| Rent Facility Costs Total Events | 500 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 9237 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 450 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 28222 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 47409 | DirectExpenseSummaryEvents |
| Net Income Summary | 25113 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 149866 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 149866 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00790 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3355487 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2138178 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1217309 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06390 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3505353 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2138178 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1367175 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07180 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 63002 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 47835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15167 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7843 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7843 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 157708 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 137933 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19775 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 300 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 300 | NetCommunityBenefitExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 228853 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 185768 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 43085 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3734206 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2323946 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1410260 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07410 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 12705 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 555 | DirectOffsettingRevenue |
| Net Community Building Expense | 12150 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 12705 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 555 | DirectOffsettingRevenue |
| Net Community Building Expense | 12150 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $538,001 | BadDebtExpenseAmount |
| Amount Attributable To | 7252 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5831309 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5819868 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 11441 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Business Name Line2 | DBA MCKENZIE HEALTH SYSTEM | BusinessNameLine2 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 DELAWARE STREET | AddressLine1 |
| City | SANDUSKY | City |
| State | MI | State |
| ZIP Code | 48471 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCKENZIE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| On Request | X | OnRequest |
| Develop Community Plan | X | DevelopCommunityPlan |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 8 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (8 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| MCKENZIE HEALTH AND WELLNESS | ||||
| 170 W ARGYLE STREET | SANDUSKY | MI | 48471 | PHYSICIAN OFFICE/PT OFFICE |
| AUSTIN STREET RURAL HEALTH CLINIC | ||||
| 51 AUSTIN STREET | SANDUSKY | MI | 48471 | RURAL HEALTH CLINIC |
| MAIN STREET HELATH CENTER | ||||
| 74 S ELK ST | SANDUSKY | MI | 48471 | PHYSICIAN ORTHOPEDIC OFFICE |
| MCKENZIE FAMILY HEALTHCARE | ||||
| 109 N DELAWARE STREET | SANDUSKY | MI | 48471 | PHYSICIAN OFFICE |
| LAKESHORE INTERNAL MEDICINE | ||||
| 7307 CHERRY STREET | PORT SANILAC | MI | 48469 | PHYSICIAN OFFICE |
| CROSWEL CLINIC | ||||
| 8 N HOWARD STREET | CROSWELL | MI | 48422 | PHSICIAN OFFICE |
| FAMILY PLANNING & GERIATRIC | ||||
| 171 N DAWSON STREET | SANDUSKY | MI | 48471 | FAMILY PLANNING & GERIATRIC SERVICES |
| SANILAC MEDICAL PLAZA | ||||
| 100 W ARGYLE STREET | SANDUSKY | MI | 48471 | PHYSICIAN OFFICE RENTAL |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED ORGANIZATION INFORMATION | PART I LINE 6A | A COMMUNITY BENEFIT REPORT WAS PREPARED DURING TAX YEAR 2013 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | MCKENZIE USES SCHEDULE H WORKSHEETS TO PREPARE THE INFORMATION IN BOX 7 USING OUR COST TO CHARGE RATIO |
| COMMUNITY BUILDING ACTIVITIES | PART II | MCKENZIES COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY BY SUPPORTING THE LOCAL COMMUNITY THROUGH VARIOUS ACTIVITIES EXAMPLES OF THESE ACTIVITES ARE THE CHAMBER OF COMMERCE SOFTBALL LEAGUE COMMUNITY SENIOR FAIR SCHOOL TOURS SANILAC 4H FAIR AND VARIOUS SHOWCASES |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | BAD DEBT FOOTNOTE IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS ON PAGE 10 NOTE 1 PARAGRAPHS 3 AND 4 |
| MEDICARE EXPLANATION | PART III LINE 8 | THERE WAS NO SHORTFALL MEDICARE COST REPORT WORKSHEETS WERE USED TO CALCULATE THE AMOUNT ON LINE 6 |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | MCKENZIESS COLLECTION POLICY REFERENCES THE CHARITY CAREFINANCIAL ASSISTANCE POLICY FOR THOSE PATIENTS THAT ARE ELIGIBLE FOR CHARITY CAREFINANCIAL ASSISTANCE AS A METHOD OF PAYMENTCOLLECTIONS |
| NEEDS ASSESSMENT | PART VI | PART VI LINE 2 THE PURPOSE OF THE 2013 MCKENZIE MEMORIAL HOSPITAL COMMUNITY NEEDS ASSESMENT WAS TO COLLECT DATA ON SPECIFIC INFORMATION REGARDING COMMUNITY PERCEPTION OF THE USE OF HEALTHCARE SERVICES COMMUNITY HEALTH AND HEALTH INSURANCE A COMPREHENSIVE NINE PAGE SURVEY WAS DEVELOPED A COVER LETTER AND SURVEY WERE SENT TO 1000 RANDOM COMMUNITY MEMBERS IN THE MCKENZIE SERVICE AREAS THE COMPANY ACCULEADS PROVIDED RANDOMIZED MAILING ADDRESSES FOR THE CITIES OF APPLEGATE CARSONVILLE DECKERVILLE LEXINGTON MARLETTE PECK PORT SANILAC SANDUSKY AND SNOVER IN ADDITION SEE ANSWER TO PART V LINE 3 ABOVE EXAMPLES OF SERVICE PROVIDED BASED ON COMMUNITY NEED ARE GERIATRICS PROGRAM IMMUNIZATIONS SPORTS PHYSICALS SENIOR FAIR HEALTH FAIRS FIRST AID BOOTH AND DIABETIC CLASSES |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | PART VI LINE 3 EVERY UNINSURED PATIENT THAT INCURS MORE THAN 1000 IN MEDICAL EXPENSES RECEIVES A CHARITY CAREFINANCIAL ASSISTANCE APPLICATION A MEDICAID APPLICATION AND HUMAN SERVICES REFERRAL ALL OTHER UNINSURED OR UNDER INSURED PATIENTS MAY REQUEST A CHARITY CAREFINANCIAL ASSISTANCE APPLICATION AT ANY TIME INSURANCE AND SELF PAY BROCHURES ARE AVAILABLE THROUTHOUT THE HOSIPTAL IN ADDITION THE SOCIAL WORKER WILL ASSIST PATIENTS WHO NEED HELP IN APPLYING FOR GOVERNMENT ASSISTANCE PROGRAMS |
| COMMUNITY INFORMATION | PART VI | PART VI LINE 4 MCKENZIE MEMORIAL HOSPITAL IS LOCATED IN SANILAC COUNTY WHICH HAS A POPULATION OF APPROXIMATELY 43000 SANILAC COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES THE UNEMPLOYMENT RATE IN SANILAC COUNTY IS 99 |
| ADDITIONAL INFORMATION | PART VI | PART III LINE 2 BAD DEBTS ARE ESTIMATED USING THE ALLOWANCE METHOD THE BAD DEBT EXPENSE LISTED ON LINE 2 IS DETERMINED USING COST BASED UPON THE COST TO CHARGE RATIO THAT IS DEVELOPED IN SCHEDULE H PART III LINE3 COST OF BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY ANALYZED FINANCIAL ASSISTANCECHARITY CARE APPLICATIONS THAT WERE DENNIED DUE TO INCOMPLETE DOCUMENTATION AND FAILURE TO PROVIDE REQUESTED INFORMATION AND APPLIED COST TO CHARGE RATIO AS DETERMINED IN SCHEDULE H THIS EXPENSE IS INCLUDED AS IT IS OUR COMMUNITY THAT CANNOT AFFORD TO PAY THEIR HEALTHCARE EXPENSES |
| MCKENZIE MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | MCKENZIE MEMORIAL HOSPITAL PARTICIPATED IN A COMMUNITY MANAGERS COMMITTEE WHICH CONSISTS OF MEMBERS FROM THE FOLLOWING ORGANIZATIONS SANILAC COUNTY SANILAC COUNTY MEDICAL FACILITY SANILAC COUNTY INTERMEDIATE SCHOOL DISTRICT SANDUSKY COMMUNITY SCHOOLS SANILAC COUNTY COMMUNITY MENTAL HEALTH CITY OF SANDUSKY SANILAC COUNTY HEALTH DEPARTMENT AND THE SANILAC ROAD COMMISSION INPUT FROM THESE ORGANIZATIONS REGARDING THE HEALTH OF OUR COMMUNITY AND ITS NEEDS IS CONSIDERED IN ADDITION MCKENZIE HELD TWO PUBLIC MEETINGS IN APRIL 2013 WHERE WE INVITED OVER 1000 PARTICIPANTS TO COME AND SHARE THEIR CONCERNS ABOUT THE HEALTH OF THE COMMUNITY PARTICIPATING COMMUNITY EMPLOYERS INCUDED THE SANILAC COUNTY COURT HOUSE SANDUSKY SCHOOLS TELLEBORG INC JENSEN BRIDGE INC AND THE SANILAC MEDICAL CARE FACILTY |
| MCKENZIE MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 7 | PART V LINE 7 | MCKENZIE MEMORIAL HOSPITAL WAS NOT ABLE TO ADDRESS ALL THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA IT WAS IDENTIFIED THAT AN EAR NOSE AND THROAT ENT SPECIALIST IS NEEDED IN SANDUSKY IT IS VERY DIFFICULT TO RECRUIT SPECIALISTS TO OUR SMALL RURAL TOWN BECAUSE OF THE LACK OF VOLUME TO SUSTAIN THIS TYPE OF SPECIALIST WE HAVE BEEN UNSUCCESSFUL RECRUITING AN ENT HOWEVER WE ARE WORKING WITH A NEIGHBORING HOSPITAL TO RECRUIT SPECIALISTS THAT WE CAN SHARE IN BOTH TOWNS WHICH WOULD PROVIDE ENOUGH VOLUME TO SUSTAIN A PRACTICE IN ADDITION WE ARE WORKING TO BRING SPECIALIST TO OUR HOSPITAL VIA TELEMEDICINE AND HAVE A TENTATIVE COMMITMENT FOR AN ENT THROUGH TELEMEDICINE TO BEGIN IN OUR NEXT FISCAL YEAR THE SECOND ITEM THAT WE WERE UNABLE TO SOLVE IS LONGER PHYSICIAN OFFICE HOURS AND WEEKEND HOURS WE ARE CURRENTLY EVALUATING THE FINANCIAL VIABILITY OF AN URGENT CARE CLINIC THE PRIMARY HURDLE IN OPERATING A LOCAL URGENT CARE CLINIC IS THE AVAILABILITY OF HEALTH CARE PROVIDERS TO STAFF THE CLINIC |
| MCKENZIE MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 22 | PART V LINE 22 | FINANCIAL ASSISTANT PROGRAM FAP ELIGIBLE PATIENTS WHO HAD SERVICES OUTSIDE OF THE EMERGENCY ROOM AND DID NOT COMPLETE A CHARITY APPLICATION WOULD HAVE BEEN CHARGED AND BILLED GROSS CHARGES HOWEVER EFFECTIVE 10113 ALL UNINSURED PATIENTS WHETHER THEY APPLY FOR FAP OR NOT RECEIVED A DISCOUNT EQUAL TO THE AVERAGE OF THE HOSPITALS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|
| DR WILLIAM STARBIRD | |||||||||
| MARLETTE PHYSICIAN | 276149 | 1025 | 11855 | 289029 | |||||
| DAN BABCOCK | |||||||||
| MARLETTE CEO | 183261 | 1025 | 1781 | 186067 | |||||
| STEVE BARNETT | |||||||||
| MCKENZIE CEOPRES | 183289 | 6291 | 15069 | 204649 | |||||
| MARK ENGLISH | |||||||||
| CHIEF OF STAFF | 159146 | 6085 | 18441 | 183672 | |||||
| DR ALFREDO DOMINGO | |||||||||
| PHYSICIAN | 387140 | 387140 | |||||||
| DR MICHAEL MERKLER | |||||||||
| PHYSICIAN | 216881 | 7637 | 14702 | 239220 | |||||
| DR JAMES SAMS | |||||||||
| PHYSICIAN | 195521 | 7054 | 6103 | 208678 | |||||
| DR MATTHEW GORMLEY | |||||||||
| PHYSICIAN | 189486 | 7110 | 15993 | 212589 | |||||
| DR MELANIE KRAMER | |||||||||
| PHYSICIAN | 204954 | 18351 | 244231 | 20926 | |||||
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BARNETT ANESTESIA INC | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | CEO'S SPOUSE | Relationship |
| Amount Of Transaction | 108013 | AmountOfTransaction |
| Description Of Transaction | CRNA SERVICES | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ANY SIGNIFICANT CHANGES IN CONDUCT FOR PROGRAM SERVICES | FORM 990, PAGE 2, PART III, LINE 3 | FAMILY PLANNING OPERATIONS WERE TAKEN OVER BY THE HEALTH DEPARTMENT PART WAY THROUGH THE FISCAL YEAR. MCKENZIE MAINTAINED THE BOOKS UNTIL THE END OF THE FISCAL YEAR. |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | MCKENZIE MEMORIAL HOSPITAL RESTATED ITS BYLAWS TO BECOME A SUBSIDARY OF THE BLUE WATER HEALTHCARE NETWORK, WHICH IS AN ASSUMED NAME OF UNITED HEALTHCARE PARTNERS AS LISTED IN SCHEDULE R. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | CLASSES OF MEMBERS THAT MAKE UP THE BOARD OF DIRECTORS |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD MEMBERS MUST BE APPROVED FIRST BY THE BOARD OF MCKENIZE HEALTHCARE CORPORATION TO BECOME BOARD MEMBERS. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | MCKENIZE HEALTHCARE CORPORATION MUST APPROVE ANY FINANCIAL TRANSACTIONS ABOVE ONE MILLION DOLLARS BEFORE ANY ACTION CAN BE TAKEN BY THE BOARD OF DIRECTORS OF MCKENZIE MEMORIAL HOSPITAL. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 IS REVIEWED BY THE FINANCE COMMITTEE FOR APPROVAL AND IS THEN SUBMITTED TO THE FULL BOARD FOR APPROVAL PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS AND ALL COMMITTEES MEMBERS ARE REQUIRED TO FILL OUT AND SIGN THE ANNUAL CONFLICT OF INTEREST POLICY FORM. IN THE EVENT OF A CONFLICT APPLICABLE BOARD MEMBERS MUST ABSTAIN FROM THE VOTE. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION OF THE CEO/PRESIDENT IS APPROVED BY THE FULL BOARD BASED ON THE RECOMMENDATION OF THE EXECUTIVE COMMITTEE THROUGH EXECUTIVE SURVEY INFORMATION. ANY EXECUTIVE BONUSES ARE APPROVED BY THE BOARD AT THE END OF A FISCAL YEAR BASED ON GOALS AND SUCCESS OF THE ORGANIZATION. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE FULL BOARD THROUGH RECOMMENDATIONS BASED ON COMPENSATION SURVEYS AND APPROVAL OF THE HOSPITAL'S ANNUAL BUDGET. BONUS AMOUNTS ARE IN THE CONTRACTS APPROVED BY THE FULL BOARD. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE HOSPITALS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION AT THE PRESIDENT/CEO'S OFFICE |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | PROFESSIONAL MEDICAL SERVICES 2,562,274 0 0 MEDICAL SERVICE CONTRACTS 217,056 0 0 ADMINISTRATIVE PROFESSIONAL 0 209,897 0 ADMINISTRATIVE SERVICE CONT. 0 136,208 0 AQUA AEROBIC INSTRUCTIONS 0 20,068 0 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MCKENIZE HEALTHCARE CORPORATION | |||||||||||
| 120 DELAWARE STREET | SANDUSKY | MI | 48471 | 382702946 | HEALTHCARE | MI | 501C3 | 3 | ITSELF | false | |
| SANILAC HEALTHCARE CORP | |||||||||||
| 120 DELAWARE STEET | SANDUSKY | MI | 48471 | 382702948 | HOMECARE | MI | 501C3 | 3 | MCKENIZE | false | HEALTHCARE CORPORATION |
| MARLETTE REGIONAL HOSPITAL | |||||||||||
| 2770 MAIN STREET PO BOX 307 | MARLETTE | MI | 48453 | 381507302 | HEALTH CAR | MI | 501C3 | 3 | UHP | false | |
| UNITED HEALTHCARE PARTNERS | |||||||||||
| 120 DELWARE STREET | SANDUSKY | MI | 48471 | 465444203 | HEALTHCARE | MI | 501C3 | 3 | ITSELF | false | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SANILAC SERVICES INC | ||||||||||
| 78 SOUTH ELK | SANDUSKY | MI | 48471 | 382774983 | PHARMACY | MI | MCKENIZE | HEALTHCARE CORPORATION | C CORP | false |
| SANILAC CATALOG INC | ||||||||||
| 78 SOUTH ELK | SANDUSKY | MI | 48471 | 383254153 | CATALOG | MI | SANILAC | SERVICES INC | C CORP | false |
| SANILAC EQUIPMENT & SUPPLY CO | ||||||||||
| 120 DELAWARE STREET | SANDUSKY | MI | 48471 | 382662256 | SUPPLIES | MI | MCKENIZE | HEALTHCARE CORPORATION | C CORP | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Business Name Line2NameOfOtherOrganization/BusinessNameLine2 | Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|---|
| SANILAC SERVICES INC | |||
| SANILAC PHARMACY | K | 15000 | FMV |
| SANILAC SERVICES INC | |||
| SANILAC PHARMACY | P | 8313 | COST BASIS |
| SANILAC SERVICES INC | |||
| SANILAC PHARMACY | Q | 90000 | COST BASIS |
| MARLETE REGIONAL HOSPITAL | |||
| O | 18457 | COST BASIS | |
| MARLETTE REGIONAL HOSPITAL | |||
| O | 269468 | COST BASIS | |