PAUL OLIVER MEMORIAL HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PAUL OLIVER MEMORIAL HOSPITAL (EIN 38-1415623)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201441349349305129
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-14T13:38:47-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381415623EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PAUL OLIVER MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPAULNameControl
Phone2313529621Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1224 PARK AVEAddressLine1
CityFRANKFORTCity
StateMIState
ZIP Code496359658ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK A HEPLERName
TitleCHIEF FINANCIAL OFFICERTitle
Phone2313529621Phone
Date Signed2014-05-13DateSigned
Authorize Third PartyfalseAuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES D AUSTINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1224 PARK AVEAddressLine1
CityFRANKFORTCity
StateMIState
ZIP Code49635ZIPCode
FieldValueIRS element (for citing)
Gross Receipts18582921GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MUNSONHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1944YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionPAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 39.9 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2011 TAX YEAR.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees190TotalNbrEmployees
Total Nbr Volunteers35TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year64605ContributionsGrantsPriorYear
Contributions Grants Current Year1109812ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17486866ProgramServiceRevenuePriorYear
Program Service Revenue CY17039128ProgramServiceRevenueCY
Investment Income Prior Year137683InvestmentIncomePriorYear
Investment Income Current Year265348InvestmentIncomeCurrentYear
Other Revenue Prior Year76678OtherRevenuePriorYear
Other Revenue Current Year152476OtherRevenueCurrentYear
Total Revenue Prior Year17765832TotalRevenuePriorYear
Total Revenue Current Year18566764TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6561317SalariesEtcPriorYear
Salaries Etc Current Year6626741SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year118006TotalFundrsngExpCurrentYear
Other Expense Prior Year9439776OtherExpensePriorYear
Other Expenses Current Year9251410OtherExpensesCurrentYear
Total Expenses Prior Year16001093TotalExpensesPriorYear
Total Expenses Current Year15878151TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1764739RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2688613RevenuesLessExpensesCY
Total Assets BOY21165084TotalAssetsBOY
Total Assets EOY20593787TotalAssetsEOY
Total Liabilities BOY3279288TotalLiabilitiesBOY
Total Liabilities EOY1430787TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY17885796NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19163000NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 39.9 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2011 TAX YEAR.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense14359086Expense
Revenue16871459Revenue
DescriptionPROVIDING HOSPITAL AND LONG-TERM CARE SERVICES TO THE RESIDENTS OF THE BENZIE, MICHIGAN REGION.Description
Total Program Service Expense14359086TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109641NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees190NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MUNSON HEALTHCAREBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2319357777TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14230 COPPER RIDGE DRAddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49684ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
PAUL M SHIRILLA
DIRECTOR40.00X030229546971
JAMES D AUSTIN
PRESIDENT24.00X02537884055516.00X
GERARD MAHONEY DO
DIRECTORX9500002.00
BRENDA SUE WEBBER
VIC CHAIRX0002.00X
CHARLES TULL
DIRECTORX0002.00
DAVID MICINSKI
DIRECTORX0002.00
HON PAUL J CLULO
CHAIRX0002.00X
IRENE A NUGENT
DIRECTORX0002.00X
JOETTA RILEY PARRIS
SEC/TREASUREX0002.00X
PAUL PATTERSON
DIRECTORX0002.00
BETSY EVANS
DIRECTORX0002.00
GEORGE RYCKMAN DO
DIRECTORX0002.00
MARK A HEPLER
CFO40.00029034359971X
PETER MARINOFF
ASST ADMINIS10788002051640.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org117380TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs846426TotalReportableCompFrmRltdOrgs
Total Other Compensation168013TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CRYSTAL LAKE EMERGE
6227 FRANKFORT HWYBENZONIAMI496169654EMERGENCY SERVI1006241
SPENCE BROTHERS
417 MCCORSKRY STSAGINAWMI48605CONSTRUCTION660225
MICHIGAN NEUROLOGY ASSOCIATES
1500 WEST PARK DR STE 390WESTBOROUGHMA01581MRI SERVICES213775
SODEXO INC AND AFFILIATES
4880 PAYSHERE CIRCLECHICAGOIL60674FOOD SERVICE168808
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events19449FundraisingEvents
Related Organizations1079645RelatedOrganizations
Government Grants10718GovernmentGrants
Total Contributions1109812TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MEDICARE AND MEDICAID PMTS62199099601479960147
PATIENT SERVICE REVENUE62199067022296702229
COMMUNITY FITNESS CENTER713940189458189458
IN HOUSE CHILD CARE624410187294$187,294
FieldValueIRS element (for citing)
Total Program Service Revenue17039128TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column77741TotalRevenueColumn
Exclusion$77,741ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real68097Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real68097Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column68097TotalRevenueColumn
Exclusion$68,097ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities183053Securities
Other4687Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other133Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities183053Securities
Other4554Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column187607TotalRevenueColumn
Exclusion$187,607ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events42089GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events19449CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses16024FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column26065TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA SALES72221030689$30,689
MISCELLANEOUS6219901962519625
AUXILIARY GIFT SHOP4461998000$8,000
FieldValueIRS element (for citing)
Total Other Revenue58314TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18566764TotalRevenueColumn
Related Or Exempt Function Income16871459RelatedOrExemptFunctionIncome
Exclusion$559,428ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4903803Total
Program Services4634956ProgramServices
Management And General268847ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total452508Total
Program Services427711ProgramServices
Management And General24797ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total905410Total
Program Services855794ProgramServices
Management And General49616ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total365020Total
Program Services345017ProgramServices
Management And General20003ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total700Total
Management And General700ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total30000Total
Management And General30000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4456552Total
Program Services3753053ProgramServices
Management And General585493ManagementAndGeneral
Fundraising118006Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total26326Total
Program Services10476ProgramServices
Management And General15850ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total370965Total
Program Services325487ProgramServices
Management And General45478ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total146971Total
Program Services137308ProgramServices
Management And General9663ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total679623Total
Program Services679623ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total71903Total
Program Services32907ProgramServices
Management And General38996ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3296Total
Program Services3296ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1019028Total
Program Services921507ProgramServices
Management And General97521ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total-59192Total
Program Services67539ProgramServices
Management And General-126731ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES13504271350427
BAD DEBT685401685401
LICENSES AND TAXES33394713992319955
MISCELLANEOUS1075329462312909

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total27931Total
Program Services19969ProgramServices
Management And General7962ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15878151Total
Program Services14359086ProgramServices
Management And General1401059ManagementAndGeneral
Fundraising118006Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1050BOY
EOY1050EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4711939BOY
EOY4599948EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2643673BOY
EOY2108588EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY117397BOY
EOY108570EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis21102402LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14498655LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6221757BOY
EOY6603747EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3285702BOY
EOY3618518EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY3862347BOY
EOY3376501EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY321219BOY
EOY176865EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21165084BOY
EOY20593787EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1011201BOY
EOY1006144EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY5000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2268087BOY
EOY419643EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3279288BOY
EOY1430787EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14023449BOY
EOY15786499EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3862347BOY
EOY3376501EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17885796BOY
EOY19163000EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21165084BOY
EOY20593787EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2688613ReconcilationRevenueExpenses
Reconcilation Other Changes-1411409ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$5,036OtherActivitiesAmount
Total Lobbying Expenditures IIB5036TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationOTHER GRASSROOTS LOBBYING INCLUDES THE PORTION OF DUES ALLOCATED TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance7148049BeginningOfYearBalance
Contributions420511Contributions
Investment Earnings Or Losses348070InvestmentEarningsOrLosses
Grants Or Scholarships906358GrantsOrScholarships
Administrative Expenses15253AdministrativeExpenses
End Of Year Balance6995019EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5253482BeginningOfYearBalance
Contributions1819941Contributions
Investment Earnings Or Losses91515InvestmentEarningsOrLosses
Administrative Expenses16889AdministrativeExpenses
End Of Year Balance7148049EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4052095BeginningOfYearBalance
Contributions757959Contributions
Investment Earnings Or Losses458819InvestmentEarningsOrLosses
Administrative Expenses15390AdministrativeExpenses
End Of Year Balance5253483EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3736794BeginningOfYearBalance
Contributions260254Contributions
Investment Earnings Or Losses288192InvestmentEarningsOrLosses
Other Expenditures224769OtherExpenditures
Administrative Expenses8376AdministrativeExpenses
End Of Year Balance4052095EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4099630BeginningOfYearBalance
Contributions332714Contributions
Investment Earnings Or Losses-535126InvestmentEarningsOrLosses
Other Expenditures149924OtherExpenditures
Administrative Expenses10500AdministrativeExpenses
End Of Year Balance3736794EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.51730BoardDesignatedEOYBalance
Term Endowment EOY Balance0.48270TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis193750OtherCostOrOtherBasis
Book Value193750BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12889626OtherCostOrOtherBasis
Depreciation8889048Depreciation
Book Value4000578BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis120618OtherCostOrOtherBasis
Depreciation28647Depreciation
Book Value91971BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7785707OtherCostOrOtherBasis
Depreciation5477200Depreciation
Book Value2308507BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis112701OtherCostOrOtherBasis
Depreciation103760Depreciation
Book Value8941BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6603747TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionINVEST IN PAUL OLIVER MEM FOUNDATIONDescription
Book Value3376501BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities3376501TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY PAYMENTS$275,181
CAREPAYMENT LIABILITY$144,462
FieldValueIRS element (for citing)
Total Of Amounts419643TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierINTENDED USES FOR ENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4ReturnReference
ExplanationTHE FUNDS ARE INTENDED FOR THE OPERATIONS AND CAPITAL NEEDS OF THE PAUL OLIVER MEMORIAL HOSPITAL. A SIGNIFICANT PORTION OF THE TEMPORARILY RESTRICTED FUNDS ARE FOR THE CAPITAL NEEDS OF THE HOSPITAL.Explanation

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Licensed StatesMILicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1
Gross Receipts Event123353GrossReceiptsEvent1
Charitable Contributions Event18125CharitableContributionsEvent1
Gross Revenue Event115228GrossRevenueEvent1
Other Direct Expenses Event17552OtherDirectExpensesEvent1
Name Of Event2FALL EVENING TONameOfEvent2
Gross Receipts Event221120GrossReceiptsEvent2
Charitable Contributions Event211324CharitableContributionsEvent2
Gross Revenue Event29796GrossRevenueEvent2
Other Direct Expenses Event27907OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events12465GrossReceiptsOtherEvents
Gross Revenue Other Events12465GrossRevenueOtherEvents
Other Direct Expenses Other Events565OtherDirectExpensesOtherEvents
Gross Receipts Total56938GrossReceiptsTotal
Charitable Contributions Total19449CharitableContributionsTotal
Gross Revenue Total Events37489GrossRevenueTotalEvents
Other Direct Expenses Total Events16024OtherDirectExpensesTotalEvents
Direct Expense Summary Events16024DirectExpenseSummaryEvents
Net Income Summary21465NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense231338TotalCommunityBenefitExpense
Net Community Benefit Expense231338NetCommunityBenefitExpense
Percent Of Total Expense0.01520PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense3855921TotalCommunityBenefitExpense
Direct Offsetting Revenue3192667DirectOffsettingRevenue
Net Community Benefit Expense663254NetCommunityBenefitExpense
Percent Of Total Expense0.04370PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense46001TotalCommunityBenefitExpense
Direct Offsetting Revenue9608DirectOffsettingRevenue
Net Community Benefit Expense36393NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense4133260TotalCommunityBenefitExpense
Direct Offsetting Revenue3202275DirectOffsettingRevenue
Net Community Benefit Expense930985NetCommunityBenefitExpense
Percent Of Total Expense0.06130PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense119640TotalCommunityBenefitExpense
Direct Offsetting Revenue63DirectOffsettingRevenue
Net Community Benefit Expense119577NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7170TotalCommunityBenefitExpense
Net Community Benefit Expense7170NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense24277TotalCommunityBenefitExpense
Net Community Benefit Expense24277NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense151087TotalCommunityBenefitExpense
Direct Offsetting Revenue63DirectOffsettingRevenue
Net Community Benefit Expense151024NetCommunityBenefitExpense
Percent Of Total Expense0.01000PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4284347TotalCommunityBenefitExpense
Direct Offsetting Revenue3202338DirectOffsettingRevenue
Net Community Benefit Expense1082009NetCommunityBenefitExpense
Percent Of Total Expense0.07130PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1229TotalCommunityBuildingExpense
Net Community Building Expense1229NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense56016TotalCommunityBuildingExpense
Net Community Building Expense56016NetCommunityBuildingExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense1641TotalCommunityBuildingExpense
Net Community Building Expense1641NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense492TotalCommunityBuildingExpense
Net Community Building Expense492NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense59378TotalCommunityBuildingExpense
Net Community Building Expense59378NetCommunityBuildingExpense
Percent Of Total Expense0.00370PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$332,660BadDebtExpenseAmount
Amount Attributable To27965AmountAttributableTo
Amount Reimbursed By Medicare5023884AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5023884CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1PAUL OLIVER MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1224 PARK AVEAddressLine1
CityFRANKFORTCity
StateMIState
ZIP Code49635ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PAUL OLIVER MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Other FactorsXOtherFactors
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PAUL OLIVER MEMORIAL HOSPITAL SNF
224 PARK AVEFRANKFORTMI49635LONG TERM CARE
PHYSICAL THERAPY
9975 W OTTAWA AVEEMPIREMI49630PT, LAB, RADIOLOGY
FITNESS CENTER
102 AIRPORT RDFRANKFORTMI49635PHYSICAL THERAPY, CARDIAC REHAB AND EDU
PHYSICAL THERAPY
6227 FRANKFORT HIGHWAYBENZONIAMI49616PT, LAB, RADIOLOGY
PHYSICAL THERAPY
1975 STIRLING DRINTERLOCHENMI49643PT, LAB, RADIOLOGY

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CAREPART I LINE 3CINCOME UP TO 200 OF THE FPG 100 DISCOUNT ON CHARGES INCOME BETWEEN 201 AND 300 FPG 75 DISCOUNT ON CHARGES INCOME BETWEEN 301 AND 400 FPG 50 DISCOUNT ON CHARGES FAMILY INCOME MAY INCLUDE ALL INCOME ATTRIBUTABLE TO ALL MEMBERS OF THE FAMILY IN THE RESIDENCE OTHER THAN MINIMAL AMOUNTS EARNED BY MINORS FAMILY INCOME INCLUDES THE FOLLOWING WHEN COMPUTING FPG INCLUDES EARNINGS UNEMPLOYMENT COMPENSATION WORKERS COMPENSATION SOCIAL SECURITY SUPPLEMENTAL SECURITY INCOME PUBLIC ASSISTANCE VETERANS PAYMENTS SURVIVOR BENEFITS PENSION OR RETIREMENT INCOME INTEREST DIVIDENDS RENTS ROYALTIES INCOME FROM ESTATES EDUCATIONAL ASSISTANCE ALIMONY CHILD SUPPORT ASSISTANCE FROM OUTSIDE THE HOUSEHOLD AND OTHER MISCELLANEOUS SOURCES CASH CHECKING AND SAVINGS BALANCES MONEY MARKET ACCOUNTS CERTIFICATES OF DEPOSIT IRAS TRUSTS INHERITANCES ANNUITIES SAVINGS BONDS STOCKS MUTUAL FUNDS ANDOR CASH VALUE OF LIFE INSURANCE
RELATED ORGANIZATION INFORMATIONPART I LINE 6AMUNSON MEDICAL CENTER BROTHER CORPORATION
SUBSIDIZED HEALTH SERVICES EXPLANATIONPART I LINE 7GTHERE ARE NO PHYSICIAN CLINICS IN SUBSIDIZED HEALTH SERVICES
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEPART I LINE 7 COLUMN FTOTAL EXPENSES FROM FORM 990 PART IX LINE 25 ARE 15878151 THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS 685401 THE NET EXPENSE OF 15192750 WAS USED FOR PURPOSES OF CALCULATING LINE 7 COLUMN F
COSTING METHODOLOGY EXPLANATIONPART I LINE 7COST VALUES FOR LINE 7 ARE BASED ON THE COST TO CHARGE RATIO COMPUTATION
COMMUNITY BUILDING ACTIVITIESPART IIPOMH PROVIDED 59379 TO COMMUNITYBUILDING ACTIVITIES DURING THE 2013 FISCAL YEAR WHILE WE BELIEVE THESE ACTIVITIES PROMOTE COMMUNITY HEALTH BY SUPPORTING THE UNDERLYING CAUSES OF COMMUNITY HEALTH THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON THE SCHEDULE H THESE ACTIVITIES INCLUDE ADMINISTRATIVE AND CASH SUPPORT FOR COALITION BUILDING ACTIVITIES IN BENZIE COUNTY MEETING THE BASIC NEEDS OF PEOPLE IN POVERTY ON A LOCAL LEVEL BY MULTIPLE COLLABORATIVE ACTIVITIES PARTICIPATION IN THE BENZIE COUNTY CHAMBER OF COMMERCE TO PROMOTE WORKFORCE DEVELOPMENT AND SEVERAL ENVIRONMENTAL IMPROVEMENTS RELATED TO COMMUNITY GARDENING AND HEALTHY SCHOOL LUNCHES ALSO BECAUSE BENZIE COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA POMH INVESTS DOLLARS INTO THE RECRUITMENT OF CRITICALLY NEEDED PHYSICIANS TO THE AREA TO PROMOTE PATIENT ACCESS TO CARE
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4PAUL OLIVER HOSPITAL UTILIZES A HINDSIGHT ANALYSIS IN THEIR DATA EVALUATION THE ESTIMATE OF THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY WAS MADE USING AN ANALYSIS OF PATIENTS WITH SPECIFIED FINANCIAL CLASSES THAT WERE TURNED OVER TO BAD DEBT STATUS THE ACCOUNTS RECEIVABLE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF MUNSON HEALTHCARE AND SUBSIDIARIES STATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND HISTORICAL WRITEOFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AFTER AMOUNTS DUE FROM THIRDPARTY PAYORS ARE SATISFIED AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PASTDUE PATIENT BALANCES WITH COLLECTION AGENCIES
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BMUNSON HEALTHCARES INTERNAL AND EXTERNAL COLLECTION PRACTICES INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT INCLUDING COLLECTIONS ACTIONS AND REPORTING TO COLLECTION AGENCIES SHALL TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY A PATIENTS GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM MUNSON HEALTHCARE AND A PATIENTS GOOD FAITH EFFORT TO COMPLY WITH HISHER PAYMENT AGREEMENTS WITH MUNSON HEALTHCARE FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS MUNSON HEALTHCARE MAY OFFER EXTENDED PAYMENT PLANS WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS ON ANY UNPAID BALANCES ON ACCOUNTS THAT WERE OPENED WITHIN ONE YEAR OF THE DATE THAT THE PATIENT QUALIFIED FOR CHARITY UNDER THIS POLICY
NEEDS ASSESSMENTPART VITHE MUNSON HEALTHCARE BOARD OF DIRECTORS MAINTAINS A STANDING COMMUNITY HEALTH COMMITTEE CHC TO SERVE THE MUNSON HEALTHCARE SYSTEM THE CHC CONSISTS OF MUNSON HEALTHCARE BOARD MEMBERS FROM MUNSON HEALTHCARE HOSPITALS AND OTHER INTERESTED AREA PHYSICIANS AND COMMUNITY MEMBERS APPOINTED BY THE MUNSON HEALTHCARE BOARD CHAIRPERSON THE CHC MEETS AT LEAST QUARTERLY TO REVIEW EXISTING PROGRAMS AND SERVICES RELATED TO CURRENT COMMUNITY HEALTH NEEDS CONSIDER THE MHC RESPONSE TO ANY EMERGING HEALTH TRENDS AS IDENTIFIED BY COMMUNITY HEALTH NEEDS ASSESSMENT AND REVIEW ANY NEW COMMUNITY HEALTH BASED COLLABORATION OR PROGRAM THE CHC IS RESPONSIBLE FOR COMMUNICATING INTERNALLY AND EXTERNALLY THE SIGNIFICANCE OF MHC COMMUNITY BENEFIT PROGRAMS AND SERVICES THIS COMMITTEE IS SUPPORTED BY A COMMUNITY HEALTH DEPARTMENT OF MUNSON MEDICAL CENTER A BROTHER CORPORATION PAUL OLIVER MEMORIAL HOSPITAL POMH A MEMBER OF THE MUNSON HEALTHCARE SYSTEM IS A CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN MUNSON HEALTHCARES EXTENSIVE GEOGRAPHICAL AREA COMMUNITY HEALTH ASSESSMENT IS AN IMPORTANT COMPONENT OF A COMMUNITY HEALTH IMPROVEMENT STRATEGY AS IT PROVIDES GUIDANCE AS TO WHERE EFFORTS SHOULD BE CONCENTRATED AS WELL AS WHERE PROGRESS HAS BEEN MADE THE DATA DOCUMENTED THROUGH AN ASSESSMENT SERVES AS A USEFUL REFERENCE FOR PROGRAM AND RESOURCE DEVELOPMENT EFFORTS COMMUNITYWIDE MUNSON MEDICAL CENTER MMC IS A SIGNIFICANT CONTRIBUTOR TO REGIONAL EFFORTS THAT ASSESS THE HEALTH STATUS OF THE TOTAL POPULATION WITHIN THE MUNSON SYSTEMS EXTENSIVE GEOGRAPHICAL AREA MUNSON MEDICAL CENTER IN CONJUNCTION WITH PAUL OLIVER MEMORIAL HOSPITAL PREPARED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY TO MEET THE REQUIREMENTS OF IRC SEC 501R DURING FISCAL 2013 IN ACCORDANCE WITH THE PLANS OF THE COMMUNITY HEALTH COMMITTEE OF THE BOARD POMH REGULARLY SEEKS INFORMATION FROM AND PARTICIPATES IN THE BENZIE COUNTY COLLABORATIVE THE LOCAL UNITED WAY AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY HEALTH NEEDS POMH IN CONJUNCTION WITH MUNSON HEALTHCARE SEEKS TO COLLABORATE WITH REGIONAL PARTNERS ASSESSING FOR EXISTING PROGRAMS AND STRATEGIES THAT ARE ALREADY WORKING WELL AND THEN PARTNERING NOT REINVENTING IF A NEW PROGRAMMING NEED IS IDENTIFIED POMH SEEKS TO POOL ASSETS WITH 4 MULTICOUNTY HEALTH DEPARTMENTS OTHER NONPROFITS AND LOCAL GOVERNMENTAL SERVICES FOR THE MOST EFFECTIVE USAGE OF RESOURCES ADDITIONALLY MUNSON HEALTHCARE WORKS IN CONJUNCTION WITH EFFORTS BY THE FIVECOUNTY COLLABORATIVES OF ANTRIM BENZIE GRAND TRAVERSE LEELANAU AND KALKASKA COUNTIES THE TRAVERSE CITY CHAMBER OF COMMERCE THE LOCAL UNITED WAY AND OTHER REGIONAL ASSOCIATIONS TO MAINTAIN CURRENT UNDERSTANDING OF COMMUNITY NEED
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIIT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE AND EDUCATE PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THIS IS ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS STATEMENT ON BILLS STATEMENTS INCLUDE VERBIAGE THAT INSTRUCTS THE PATIENT TO CALL PATIENT FINANCIAL ASSISTANCE IF THEY NEED HELP WITH THEIR BILL SIGNS IN THE ER REGISTRATION AREA ADVISES THE PATIENTS THAT THEIR CARE IS NOT WITHHELD IF THEY HAVE NO INSURANCE OR MEANS TO PAY REFERRAL BY REGISTRATION STAFF AT THE TIME OF REGISTRATION SELFPAY PATIENTS OR ANY PATIENT THAT MAY HAVE CONCERNS REGARDING THEIR UPCOMING ADMISSION IS REFERRED TO THE FINANCIAL COUNSELING STAFF PAUL OLIVER MEMORIAL HOSPITAL FINANCIAL COUNSELORS ARE AVAILABLE TO TALK WITH PATIENTS ABOUT THEIR FINANCIAL CONCERNS IF THE PATIENT WOULD LIKE HELP THE COUNSELORS GATHER INCOME INFORMATION AND SCREEN THE PATIENT FOR MEDICAID ONCE THE COUNSELOR DETERMINES WHAT THE PATIENT MAY QUALIFY FOR THE COUNSELOR EDUCATES THE PATIENT ON THE AVAILABLE PROGRAMS AND ASSISTS THEM WITH COMPLETING THE APPROPRIATE APPLICATIONS AVAILABLE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO MEDICAID AND ALL OF ITS SUBSETS SOCIAL SECURITY DISABILITY TRAVERSE HEALTH CLINIC CHARITY CARE CATASTROPHIC CARE COVERAGE AND CAREPAYMENT
COMMUNITY INFORMATIONPART VIPAUL OLIVER MEMORIAL HOSPITAL POMH IS LOCATED IN FRANKFORT MICHIGAN ONE OF SEVEN HOSPITALS IN THE MUNSON HEALTHCARE SYSTEM POMH OFFERS QUALITY PERSONALIZED CARE FOR PRIMARY AND URGENT MEDICAL NEEDS DUE TO ITS RURAL GEOGRAPHIC LOCATION POMH IS DESIGNATED AS A MICHIGAN CRITICAL ACCESS HOSPITAL LABORATORY RADIOLOGY AND REHABILITATION SERVICES AT POMH ARE NETWORKED WITH MUNSON MEDICAL CENTER MMC BROTHER ORGANIZATION ENSURING PROMPT AND CONVENIENT DIAGNOSIS AND TREATMENT POMH HAS 8 ACUTE CARE BEDS AS WELL AS A 39BED EXTENDED CARE UNIT WHERE RESIDENTS ENJOY A SAFE WARM AND COMFORTABLE HOMELIKE SETTING FOUNDED ON PRINCIPLES OF QUALITY AND PERSONAL CARE BECAUSE THE CARE CENTER IS HOSPITALBASED PHYSICIANS AND EMERGENCY MEDICAL CARE ARE AVAILABLE 24 HOURS A DAY HOSPITAL SERVICES POMH PROVIDES 24HOUR EMERGENCY CARE ACUTE CARE LONGTERM CARE OUTPATIENT SURGICAL SERVICES AND RESPITE CARE MMC SPECIALISTS REGULARLY HOLD CLINICS AT POMH MAKING IT EASY TO RECEIVE SPECIALIZED CARE POPULATION SERVED BY PAUL OLIVER MEMORIAL HOSPITAL IN THE POMH MAIN SERVICE AREA OF BENZIE COUNTY 22 OF THE POPULATION IS 65 YEARS OR OLDER UNEMPLOYMENT IS 12 OR HIGHER 16 OF ADULTS AGED 1864 YEARS OF AGE LACK HEALTH INSURANCE 13 LIVE BELOW THE FEDERAL POVERTY LEVEL QUALITY PAUL OLIVER MEMORIAL HOSPITAL HAS RECEIVED THE FOLLOWING AWARDS 2009 2010 2011 AND 2012 SUMMIT AWARD FOR EMERGENCY CARE FROM PRESS GANEY ASSOCIATES INC POMH ALSO WON A SUMMIT AWARD IN 2011 FOR ITS OUTPATIENT CARE THE SUMMIT AWARD NOW CALLED THE GUARDIAN OF EXCELLENCE AWARD IS PRESENTED FOR RANKING IN THE TOP 5 PERCENT IN THE NATION FOR PATIENT SATISFACTION FOR 12 CONSECUTIVE QUARTERS 2013 GUARDIAN OF EXCELLENCE AWARDS FOR OUTPATIENT CARE AND EMERGENCY CARE THE 2009 2010 AND 2011 MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT AWARD OF EXCELLENCE FOR ITS COMMITMENT TO QUALITY CARE AND EVIDENCEBASED MEDICINE IN THE AREA OF EMERGENCY ROOM TRANSFERS 2010 AND 2011 MICHIGAN RURAL HEALTH QUALITY IMPROVEMENT EXCELLENCE FOR ITS COMMITMENT TO OUTPATIENT CARE THE GOVERNORS AWARD OF EXCELLENCE FOR IMPROVING PATIENT SAFETY AND QUALITY OF CARE IN THE CRITICAL ACCESS SETTING THE AWARD HONORS MICHIGAN HOSPITALS THAT PERFORM QUALITY INITIATIVES AIMED AT IMPROVING PATIENT CARE THE HOSPITAL HAS REPEATEDLY RECEIVED THIS AWARD MOST RECENTLY IN 2012
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VITHE POMH BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS THE MAJORITY OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE TO THE HOSPITAL IN THEIR OVERSIGHT ROLE THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS IN FUNDRAISING AND IN GENERAL STEWARDSHIP ALL BOARD MEMBERS SUPPORT THE HOSPITAL FINANCIALLY MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY SUBJECT TO CREDENTIALING REVIEW AND REQUIREMENTS OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS POMH UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND IMPROVE CARE TO PATIENTS THROUGHOUT ITS SERVICE AREA A DESCRIPTION OF SEVERAL SIGNIFICANT PROGRAMS INITIATED BY THE HOSPITAL FOLLOWS HEALTHY FUTURES A PARTNERSHIP OF AREA HEALTH CARE PROVIDERS HEALTH DEPARTMENTS AND MUNSON HEALTHCARE MUNSON HEALTHCARE SYSTEM PARENT AND SOLE MEMBER CREATED TO IMPROVE THE HEALTH OF PREGNANT WOMEN AND CHILDREN UNDER AGE TWO THE HEALTHY FUTURES MODEL OF RN CARE COORDINATION CONSISTS OF AN OUTCOMESBASED APPROACH TO INTERVENTION IN THE AREAS OF BREASTFEEDING LONGEVITY ACCESS TO HEALTH CARE AND IMMUNIZATIONS BECAUSE OF THE RURAL NATURE OF THE COMMUNITY TRAVEL TIME TO THE NEAREST MATERNAL CHILD HEALTHCARE SPECIALIST MAY BE GREATER THAN 30 MINUTES COST AND AVAILABILITY OF TRANSPORTATION CAN BE A DIFFICULT BARRIER TO ACCESS HEALTHCARE FOR YOUNG FAMILIES POMH PARTNERS WITH MUNSON MEDICAL CENTER TO BRING MATERNAL CHILD HEALTHCARE SPECIALISTS TO PAUL OLIVER MAKING IT EASY AND CONVINENT TO RECEIVE THE SPECIALIZED CARE NEEDED TRANSPORTATION AS PART OF MUNSON HEALTHCARE POMH SUBSIDIZES FUNDING FOR COUNTY TRANSPORTATION AUTHORITIES WHICH PROVIDES ACCESS TO HEALTHCARE SERVICES FOR DISADVANTAGED PERSONS SUCH AS THE ELDERLY PERSONS WITH DISABILITIES AND PERSONS OF LOW INCOME WHO HAVE DIFFICULTY PROVIDING THEIR OWN TRANSPORTATION BETSIE HOSICK HEALTH AND FITNESS CENTER THE BETSIE HOSICK HEALTH AND FITNESS CENTER IS OPEN TO PEOPLE OF ALL AGES ABILITIES AND FITNESS LEVELS TO ACHIEVE BETTER HEALTH THE FITNESS CENTER OFFERS A FULL RANGE OF FITNESS EQUIPMENT AND CLASSES MEDICALLY CREDENTIALED FITNESS PROFESSIONALS ARE ON STAFF TO ASSIST MEMBERS THROUGH THE BETSIE HOSICK HEALTH AND FITNESS CENTER SENIOR MOVEMENT AND BALANCE CLASSES ARE HELD AT SENIOR SITES AROUND THE COUNTY FREE OF CHARGE TO PROMOTE WELLNESS PAUL OLIVER HOLDS NUTRITIONAL EDUCATION CLASSES FOR COMMUNITY MEMBERS AT THE HOSPITAL CAREGIVER LIBRARY A LIBRARY INCLUDING COMPUTERS TO ASSIST THE PUBLIC TO OBTAIN HEALTHCARE INFORMATION SUPPORT GROUPS AND ASSISTANT ACTIVITIES FOR CHRONIC DISEASES SUCH AS ALZHEIMERS DISEASE PARKINSONS AND CANCER SCREENING SERVICES SUCH AS BLOOD PRESSURE CHECKS MAMMOGRAMS AND LABORATORY TESTS TO THOSE IN NEED NORTHERN MICHIGAN DIABETES INITIATIVE NMDI NORTHERN MICHIGAN DIABETES INITIATIVE NMDI A GROUP OF STAKEHOLDERS AND STEERING COMMITTEE MEMBERS THAT REPRESENT THE 11 COUNTY SERVICE AREA WITH A VISION TO IMPROVE THE CHRONIC CARE MANAGEMENT OF DIABETES NMDI IS COMMITTED TO PROVIDING LOCAL REGIONAL AND NATIONAL RESOURCES FOR THE PREVENTION AND MANAGEMENT OF DIABETES WHILE MOST DIABETES COLLABORATIVES FOCUS ON PROVIDING OPTIMAL EVIDENCE BASED CARE MANAGEMENT TO THE PERSON ALREADY DIAGNOSED WITH DIABETES NMDI FOCUSES ON CONCURRENT UPSTREAM TARGETED EDUCATION OF THREE SPECIFIC POPULATIONS THE GENERAL COMMUNITY THE SOCIOECONOMICALLY CHALLENGED HIGH RISK POPULATION AND RURAL PRIMARY CARE PROVIDERS PCP CARING FOR DIABETIC PATIENTS COLLABORATION WITH THE TRAVERSE HEALTH CLINIC THE TRAVERSE HEALTH CLINIC THC PROVIDES ACCESS TO AFFORDABLE HEALTH SERVICES THROUGH COMMUNITY COLLABORATION TO PEOPLE IN NEED IN BENZIE LEELANAU AND GRAND TRAVERSE COUNTIES THC SERVES AS A PRIMARY CARE PROVIDER FOR THOSE ADULTS WITH MEDICAID AND RUNS THE COALITION HEALTH ACCESS PROGRAM CHAP FOR THOSE ADULTS WITH NO INSURANCE WHO QUALIFY INCOME 200 OF FPG POMH DONATES LABS XRAYS AND OTHER SERVICES TO THC PATIENTS LIVING IN THEIR RURAL SERVICE AREA
AFFILIATED HEALTH CARE INFORMATIONPART VIPAUL OLIVER MEMORIAL HOSPITAL IS A MEMBER OF THE MUNSON HEALTHCARE SYSTEM A COMMUNITYOWNED HEALTH SYSTEM THAT INCLUDES SEVEN ACUTE CARE HOSPITALS AS WELL AS NUMEROUS OUTPATIENT SERVICES AND CLINICS ALL THE HOSPITALS IN THE SYSTEM ARE AFFILIATED WITH EACH OTHER AND SERVE AS THE ONLY HOSPITALS IN THEIR RESPECTIVE COMMUNITIES EACH OF THE AFFILIATED HOSPITALS HAS INDIVIDUAL INITIATIVES ANDOR PROMOTION ACTIVITIES AS WELL AS SHARED INITIATIVES PAUL OLIVERS SOLE CORPORATE MEMBER IS MUNSON HEALTHCARE A 501C3 CORPORATION AFFILIATES OTHER THAN THE HOSPITALS INCLUDE TWO FOUNDATIONS HOME HEALTH ORGANIZATIONS MOBILE IMAGING COMPANIES AND AN EMERGENCY TRANSPORTATION ORGANIZATION ALL 501C ENTITIES IN ADDITION TO DIRECTING COMMUNITY BENEFIT ACTIVITIES OF THE SYSTEM MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFITS PROGRAMS FOR THE SYSTEM THROUGH PLANNING DEVELOPING IMPLEMENTING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS POMH WORKS IN COOPERATION WITH OTHER ENTITIES IN THE MUNSON HEALTHCARE SYSTEM TO PROVIDE A FULL RANGE OF HEALTH SERVICES TO THE COMMUNITIES IN ITS SERVICE AREA THE HOME HEALTH DIVISION OF MUNSON HEALTHCARE PROVIDES HOME NURSE AND AIDE SERVICES IN ADDITION TO DURABLE MEDICAL EQUIPMENT A PALLIATIVE CARE PROGRAM AND A HOSPICE PROGRAM ON THE MUNSON MEDICAL CENTER CAMPUS CLOSE TO 210000 DOLLARS IN COMMUNITY BENEFIT IN THE FORM OF CHARITY CARE AND UNREIMBURSED MEDICAID ARE PROVIDED THROUGH THIS DIVISION EACH YEAR NORTH FLIGHT INC IS THE CHARITABLE TRANSPORTATION ENTITY IN THE SYSTEM WITH ITS FIXED WING AND HELICOPTER AIR SERVICES IN COMBINATION WITH GROUND TRANSPORT PATIENTS IN THE SYSTEM ARE ABLE TO ACCESS APPROPRIATE CARE NORTH FLIGHT INC PROVIDED 12 MILLION IN CHARITY CARE AND UNREIMBURSED MEDICAID IN THE PAST FISCAL YEAR MUNSON MEDICAL GROUP THE EMPLOYED PHYSICIAN ORGANIZATION IN THE SYSTEM PROVIDED OVER A HALF MILLION DOLLARS IN CHARITY CARE AND COMMUNITY BENEFIT IN TAX YEAR 2012 PAUL OLIVER MEMORIAL HOSPITAL PARTICIPATES IN MUNSON HEALTHCARE SYSTEM NEEDS ASSESSMENT PROCESS UTILIZING THIS NEEDS ASSESSMENT MUNSON HEALTHCARE COORDINATES COMMUNITY BENEFIT PROGRAMS THROUGH PLANNING DEVELOPING IMPLEMENTING EVALUATING AND FUNDING PROGRAMS THAT ADDRESS COMMUNITY NEEDS IN TOTAL THE MUNSON HEALTHCARE SYSTEM PROVIDED 419 MILLION IN CHARITY CARE AND COMMUNITY BENEFITS INCLUDING NUMEROUS UNCOMPENSATED COMMUNITY HEALTH IMPROVEMENT SERVICES AND PROGRAMS OUTREACH PROGRAMS BAD DEBT AND UNREIMBURSED MEDICARE AND MEDICAID SERVICES TO NORTHERN MICHIGAN
PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 3PART V LINE 3A COLLABORATIVE 12MEMBER STEERING COMMITTEE GUIDED THE CHNA PROCESS THIS STEERING COMMITTEE WAS COMPRISED OF HOSPITAL LEADERS AND PUBLIC HEALTH OFFICIALS AS THE CHNA PROCESS PROGRESSED 129 INDIVIDUALS FROM MULTIPLE AREA ORGANIZATIONS WERE INVOLVED TO ENSURE INPUT FROM THOSE WHO HAVE A BROAD KNOWLEDGE OF THE COMMUNITY FURTHER A GROUP OF KEY PHYSICIAN LEADERS FROM THE REGION ALSO WAS CONSULTED FOR INPUT INDIVIDUALS POSSESSING BROAD KNOWLEDGE OF ALL SEGMENTS OF THE FIVECOUNTY AREA PARTICIPATED IN 10 FOCUS GROUPS TO HELP ASSESS HEALTH CARE NEEDS SESSIONS WERE CONDUCTED WITH FIVE AREA COUNTY COLLABORATIVES AS WELL AS PEOPLE LIVING IN POVERTY YOUTH THOSE WHO PROVIDE SERVICES TO SENIORS AND BEHAVIORAL HEALTH PROVIDERS THESE GROUPS WERE SELECTED BECAUSE OF THEIR KNOWLEDGE OF PEOPLE AND AREAS MOST IMPACTED BY HEALTH DISPARITIES BEHAVIORAL HEALTH PROVIDERS WERE AN IMPORTANT INITIAL FOCUS GROUP BECAUSE THERE IS ALMOST NO SECONDARY MENTAL HEALTH DATA AVAILABLE FOCUS GROUPS SERVING A SPECIFIC POPULATION IE SENIORS BEHAVIORAL HEALTH WERE ASKED ABOUT HEALTH NEEDS SPECIFIC TO THE GROUPS AREA OF EXPERTISE EACH FOCUS GROUP DETERMINED A COMPREHENSIVE LIST OF HEALTH NEEDS THEN PRIORITIZED ITS TOP FOUR TO SIX HEALTH NEEDS IN ADDITION SIXTEEN KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN JANUARY 2012 TO JULY 2012 WITH INDIVIDUALS FROM THE COURTS AREA FOUNDATIONS FREE AND FEDERALLY QUALIFIED HEALTH CENTER CLINICS THE MIGRANT CLINIC THE TRIBAL CLINIC ORGANIZATIONS WHO SERVE SENIORS AND ADOLESCENT HEALTH CLINIC PROVIDERS TO ASSESS THE GREATEST HEALTH NEEDS THEY OBSERVE KEY INFORMANTS WERE ASKED THE SAME FOUR QUESTIONS AS THE FOCUS GROUPS FOCUSING ON THEIR SPECIFIC POPULATION AREA OF EXPERTISE KEY INFORMANTS WERE CHOSEN BECAUSE OF THEIR KNOWLEDGE OF PEOPLE AND AREAS MOST IMPACTED BY HEALTH DISPARITIES
PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 4PART V LINE 4MUNSON MEDICAL CENTER
PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 7PART V LINE 7LARGE HEALTH NEEDS NOT ADDRESSED BY POMH AT THIS TIME ARE MENTAL HEALTH AND SUBSTANCE ABUSE POMH DOES NOT HAVE THE RESOURCES FOR MENTAL HEALTH OUTREACH OR AN INPATIENT PSYCHIATRIC UNIT OUR REFERRALS FOR MENTAL HEALTH AND SUBSTANCE ABUSE CARE THAT CANNOT BE TREATED IN THE PRIMARY CARE SETTING ARE SENT TO MUNSON MEDICAL CENTER IN TRAVERSE CITY OR PINE REST IN GRAND RAPIDS OUR GOAL IS TO WORK WITH PRIMARY CARE GROUPS TO IDENTIFY OPPORTUNITIES FOR ESTABLISHMENT OF GREAT ACCESS TO OUTPATIENT MENTAL HEALTH SERVICES IN THE REGION AND A PAIN CLINIC FOR IMPROVED MANAGEMENT IN ADDITION POMH DOES NOT HAVE THE ABILITY TO ADDRESS DENTAL NEEDS AT THIS TIME ACCESS TO DENTAL HEALTH PROVIDERS IS AN ISSUE IN MANY RURAL REGIONS ALTHOUGH OUR OPTIONS ARE LIMITED IN THIS AREA WE WILL CONTINUE TO EXPLORE WAYS TO DEVELOP COLLABORATIVE OPPORTUNITIES WITH DENTAL CLINICS NORTH TO EXPAND FROM GRAND TRAVERSE COUNTY INTO BENZIE COUNTY OUR COORDINATION WITH MUNSON HEALTHCARE ON HOW TO EXPAND PERINATAL SERVICES FOR GREATER ACCESS IN THE REGION IS ONGOING WE DO NOT VIEW THIS AS DIRECTLY ADDRESSING THE NEEDS OF PERINATAL AND OBSTETRICAL SERVICES
PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 12HPART V LINE 12HPATIENTS WHOSE FAMILY INCOME EXCEEDS 400 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES IE HIGH DEBTTOINCOME RATIO AT THE SOLE DISCRETION OF MUNSON HEALTHCARE
PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 14GPART V LINE 14GIT IS THE GOAL OF MUNSON HEALTHCARE TO COMMUNICATE TO THE PATIENTS AND TO THE PUBLIC THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY THIS WILL BE ACHIEVED THROUGH ONE OR MORE OF THE FOLLOWING METHODS INFORMATION BROCHURES AVAILABLE AT THE REGISTRATION DESKS INFORMATION POSTED ON THE WEBSITE STATEMENT ON BILLS ANDOR SIGNS IN THE REGISTRATION AREAS
PAUL OLIVER MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 20DPART V LINE 20DSELFPAYNO INSURANCE PATIENTS ARE GIVEN A DISCOUNT EQUAL TO 15 OFF THEIR TOTAL BILL FOR ALL MEDICALLY NECESSARY AND EMERGENCY SERVICES THIS RATE WAS DETERMINED BY TAKING THE AVERAGE OF COMMERCIAL RATES NOT INCLUDING BLUE CROSS

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PAUL M SHIRILLA
DIRECTOR2647933361538873202514946349266
JAMES D AUSTIN
PRESIDENT180540392353401323077174782943433698
MARK A HEPLER
CFO241424318441707539379205923503144348

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED ORG METHODS USED FOR COMPENSATION EXPLANATIONSCHEDULE J, PAGE 1, PART I, LINE 3THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD TO THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALIFY, COMMUNITY HEALTH, AND OPERATIONAL THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE MUNSON FOUNDATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSSCHEDULE J, PAGE 1, PART I, LINE 4PAUL M. SHIRILLA 0 16,138 0 JAMES D. AUSTIN 0 12,244 0 MARK A. HEPLER 0 24,893 0
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIIEXECUTIVE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE FUNDS ARE AVAILABLE TO VESTED PARTICIPANTS UPON SEPARATION OF EMPLOYMENT FROM MUNSON.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
CRYSTAL LAKE CLINIC
OWNER DIRECTOR58214MEDICAL SERVICESfalse
CRYSTAL LAKE EMERGENCY SERVICES PC
OWNER DIRECTOR942770GROUP PHYSICIAN PRACfalse
NRTW LLC
OWNER DIRECTOR62247LEASEfalse
INTERLOCHEN MEDICAL PROPERTIES LLC
OWNER DIRECTOR81547LEASEfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONPAUL OLIVER MEMORIAL HOSPITAL DELIVERS QUALITY HEALTHCARE FOR THE PEOPLE OF THE BENZIE REGION TO IMPROVE THE HEALTH OF THE COMMUNITY IN PARTNERSHIP WITH MUNSON HEALTHCARE. PAUL OLIVER MEMORIAL HOSPITAL'S EXEMPT PURPOSE IS TO OPERATE A HOSPITAL, LONG-TERM CARE FACILITY AND OTHER ANCILLARY FACILITIES TO PROMOTE AND IMPROVE THE HEALTH OF THE RESIDENTS OF THE BENZIE, MICHIGAN AREA. PAUL OLIVER MEMORIAL HOSPITAL IS PART OF THE MUNSON HEALTHCARE SYSTEM. THROUGH ITS HOSPITALS AND OTHER AFFILIATES, THE SYSTEM DELIVERS A BROAD ARRAY OF HEALTH CARE SERVICES TO 24 COUNTIES IN MICHIGAN'S NORTHERN LOWER PENINSULA AND THE EASTERN PORTION OF THE UPPER PENINSULA. CONSISTENT WITH ITS MISSION, THE MUNSON HEALTHCARE SYSTEM PROVIDED 39.9 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS, INCLUDING BAD DEBT AND THE SYSTEM MEDICARE FUNDS SHORTFALL FOR RESIDENTS OF NORTHERN MICHIGAN IN THE 2011 TAX YEAR.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6PAUL OLIVER MEMORIAL HOSPITAL IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ADIRECTORS ARE ELECTED FROM AMONG THOSE PERSONS RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE AT THE MUNSON HEALTHCARE ANNUAL MEETING.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BCERTAIN DECISIONS OF THE PAUL OLIVER MEMORIAL HOSPITAL DIRECTORS ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF PAUL OLIVER MEMORIAL HOSPITAL; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; CHANGE IN SCOPE OF SERVICES OR PROGRAMS PROVIDED BY PAUL OLIVER MEMORIAL HOSPITAL; AND APPOINTMENT OF THE PRESIDENT.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE PAUL OLIVER MEMORIAL HOSPITAL BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. PAUL OLIVER MEMORIAL HOSPITAL BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BCOMPENSATION OF OTHER OFFICERS IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES PAUL OLIVER MEMORIAL HOSPITAL AND MUNSON HEALTHCARE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE PAUL OLIVER MEMORIAL HOSPITAL ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. PAUL OLIVER MEMORIAL HOSPITAL DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
GROUP RETURN METHODFORM 990, PAGE 7, PART VIIPARENT ORGANIZATION HAS FILED A SEPARATE RETURN
OTHER FEES FOR SERVICESFORM 990, PART IX, LINE 11GPURCHASED SERVICES 2,787,530 575,100 118,006 PROFESSIONAL FEES 965,523 10,393 0
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9INVESTMENT IN SUB - PAUL OLIVER HOSPITAL FND 420,511 UNREALIZED INVESTEMENT GAIN 74,438 TRANSFER TO PARENT CORP -1,000,000 TEMP REST ASSET TRANSFER -906,358 -

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Business Name Line2DirectControllingEntityName/BusinessNameLine2Controlled OrgControlledOrg
MUNSON DIALYSIS CENTER
1105 SIXTH STTRAVERSE CITYMI49684383097861DIALYSISMIC33MUNSON HCMUNSON HEALTHCAREfalse
MUNSON HEALTHCARE
1105 SIXTH STTRAVERSE CITYMI49684382640544PARENTMIC311BNAfalse
MUNSON HEALTHCARE REGIONAL FOUNDATI
1105 SIXTH STTRAVERSE CITYMI49684382642724RAISE FUNDMIC37MUNSON HCMUNSON HEALTHCAREfalse
MUNSON HOME CARE
1105 SIXTH STTRAVERSE CITYMI49684382191390HOME HEALTMIC39MUN HOME HMUNSON HOME HEALTHfalse
MUNSON HOME HEALTH
1105 SIXTH STTRAVERSE CITYMI49684383335362HOME HEALTMIC311BMUNSON HCHEALTHCAREfalse
MUNSON HOME SERVICES
1105 SIXTH STTRAVERSE CITYMI49684382543463HOME HEALTMIC39MUN HOME HMUNSON HOME HEALTHfalse
MUNSON MEDICAL CENTER
1105 SIXTH STTRAVERSE CITYMI49684381362830HOSPITALMIC33MUNSON HCMUNSON HEALTHCAREfalse
NORTH FLIGHT INC
1105 SIXTH STTRAVERSE CITYMI49684382657917MED TRANSPMIC311BMUNSON HCMUNSON HEALTHCAREfalse
PAUL OLIVER MEMORIAL HOSPITAL FOUND
1105 SIXTH STTRAVERSE CITYMI49684237201619RAISE FUNDMIC33PAUL OLIVEPAUL OLIVER MEMORIAL HOSPITALtrue
MUNSON MEDICAL GROUP
1105 SIXTH STTRAVERSE CITYMI49684273600575HEALTHCAREMIC39MUNSON MEDMUNSON MEDICAL CENTERfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNADisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
MUNSON MEDICAL BUILDING PARTNERS
PO BOX 1188TRAVERSE CITYMI496851188382830005REAL ESTATMIN/Afalsefalse
NORTHERN MICHIGAN SUPPLY ALLIANCE
2651 AERO PARK DRTRAVERSE CITYMI49686383453378PURCHASINGMIN/Afalsefalse
MUNSON MEDICAL BUILDING PARTNERS
PO BOX 1188TRAVERSE CITYMI496851188382830005REAL ESTATMIN/Afalsefalse
NORTHERN MICHIGAN SUPPLY ALLIANCE
2651 AERO PARK DRTRAVERSE CITYMI49686383453378PURCHASINGMIN/Afalsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (12 entries)

Business Name Line2NameOfRelatedOrg/BusinessNameLine2Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
MEDICAL OFFICE BUILDING CONDOMINIUM
MEDICAL OFFICE BUILDING CONDOMINIUMPO BOX 1188TRAVERSE CITYMI496851188383567278REAL ESTATMIN/Afalse
MUNSON SERVICES INC
PO BOX 1188TRAVERSE CITYMI496851188383144382PHARMACYMIN/Afalse
MUNSON SUPPORT SERVICES
PO BOX 1188TRAVERSE CITYMI496851188382872821LAUNDRYMIN/Afalse
SIXTH STREET DRUGS INC
PO BOX 1188TRAVERSE CITYMI496851188382298290PHARMACYMIN/Afalse
MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUMPO BOX 1188TRAVERSE CITYMI496851188201902620REAL ESTATMIN/Afalse
MUNSON MOBILE IMAGING
PO BOX 1188TRAVERSE CITYMI496851188382704069IMAGINGMIN/Afalse
MEDICAL OFFICE BUILDING CONDOMINIUM
MEDICAL OFFICE BUILDING CONDOMINIUMPO BOX 1188TRAVERSE CITYMI496851188383567278REAL ESTATMIN/Afalse
MUNSON SERVICES INC
PO BOX 1188TRAVERSE CITYMI496851188383144382PHARMACYMIN/Afalse
MUNSON SUPPORT SERVICES
PO BOX 1188TRAVERSE CITYMI496851188382872821LAUNDRYMIN/Afalse
SIXTH STREET DRUGS INC
PO BOX 1188TRAVERSE CITYMI496851188382298290PHARMACYMIN/Afalse
MEDICAL OFFICE CONDOMINIUM
MEDICAL OFFICE CONDOMINIUMPO BOX 1188TRAVERSE CITYMI496851188201902620REAL ESTATMIN/Afalse
MUNSON MOBILE IMAGING
PO BOX 1188TRAVERSE CITYMI496851188382704069IMAGINGMIN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (42 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDeterminationBusiness Name Line2NameOfOtherOrganization/BusinessNameLine2
MUNSON DIALYSIS CENTER
J65985FMV
MUNSON HEALTHCARE
B1000000FMV
MUNSON HEALTHCARE
M165372FMV
MUNSON HEALTHCARE
O135156FMV
MUNSON HEALTHCARE
P115267FMV
MUNSON HEALTHCARE REGIONAL FOUNDATI
C173287FMVFOUNDATION
MUNSON MEDICAL CENTER
P6135851FMV
MUNSON MEDICAL CENTER
O1044383FMV
MUNSON MEDICAL CENTER
M811113FMV
MUNSON SERVICES INC
M56456FMV
MUNSON SUPPORT SERVICES
M84319FMV
NORTHERN MICHIGAN SUPPLY ALLIANCE
P225210FMV
PAUL OLIVER MEM HOS FOUNDATION
M117970FMV
PAUL OLIVER MEM HOS FOUNDATION
C906358FMV
MUNSON DIALYSIS CENTER
J65985FMV
MUNSON HEALTHCARE
B1000000FMV
MUNSON HEALTHCARE
M165372FMV
MUNSON HEALTHCARE
O135156FMV
MUNSON HEALTHCARE
P115267FMV
MUNSON HEALTHCARE REGIONAL FOUNDATI
C173287FMVFOUNDATION
MUNSON MEDICAL CENTER
P6135851FMV
MUNSON MEDICAL CENTER
O1044383FMV
MUNSON MEDICAL CENTER
M811113FMV
MUNSON SERVICES INC
M56456FMV
MUNSON SUPPORT SERVICES
M84319FMV
NORTHERN MICHIGAN SUPPLY ALLIANCE
P225210FMV
PAUL OLIVER MEM HOS FOUNDATION
M117970FMV
PAUL OLIVER MEM HOS FOUNDATION
C906358FMV
MUNSON DIALYSIS CENTER
J65985FMV
MUNSON HEALTHCARE
B1000000FMV
MUNSON HEALTHCARE
M165372FMV
MUNSON HEALTHCARE
O135156FMV
MUNSON HEALTHCARE
P115267FMV
MUNSON HEALTHCARE REGIONAL FOUNDATI
C173287FMVFOUNDATION
MUNSON MEDICAL CENTER
P6135851FMV
MUNSON MEDICAL CENTER
O1044383FMV
MUNSON MEDICAL CENTER
M811113FMV
MUNSON SERVICES INC
M56456FMV
MUNSON SUPPORT SERVICES
M84319FMV
NORTHERN MICHIGAN SUPPLY ALLIANCE
P225210FMV
PAUL OLIVER MEM HOS FOUNDATION
M117970FMV
PAUL OLIVER MEM HOS FOUNDATION
C906358FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE RReturnReference
ExplanationPAUL OLIVER MEMORIAL HOSPITAL USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTSExplanation

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