COREWELL HEALTH: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-1297435)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-05
- IRS object ID
- 201301259349300255
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-05T19:00:26-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 West Madison Street | AddressLine1 |
| Address Line2 | Suite 700 | AddressLine2 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 606024903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381297435 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH KELSEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SPEC | NameControl |
| Phone | 6167747322 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S Bower | AddressLine1 |
| City | Greenville | City |
| State | MI | State |
| ZIP Code | 488382628 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RYAN K JOHNSON | Name |
| Title | VP OF FINANCE | Title |
| Date Signed | 2013-04-23 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Geralyn R Hurd | Name |
| PTIN | P00933422 | PTIN |
| Phone | 3128997000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTINA FREESE-DECKER | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S Bower | AddressLine1 |
| City | Greenville | City |
| State | MI | State |
| ZIP Code | 488382628 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16969746 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://WWW.SPECTRUMHEALTH.ORG/KELSEY | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1945 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 173 | TotalNbrEmployees |
| Total Nbr Volunteers | 4 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 17812 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 121676 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14915959 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16824168 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -25172 | InvestmentIncomePriorYear |
| Investment Income Current Year | -329 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 38360 | OtherRevenuePriorYear |
| Other Revenue Current Year | 23404 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14946959 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16968919 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7524985 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8930627 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7306262 | OtherExpensePriorYear |
| Other Expenses Current Year | 7639098 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14831247 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16569725 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 115712 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 399194 | RevenuesLessExpensesCY |
| Total Assets BOY | 4041984 | TotalAssetsBOY |
| Total Assets EOY | 5140109 | TotalAssetsEOY |
| Total Liabilities BOY | 1143182 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1786218 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2898802 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3353891 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 15535107 | Expense |
| Grants | 0 | Grants |
| Revenue | 16846745 | Revenue |
| Description | SPECTRUM HEALTH KELSEY (SHK) HOSPITAL IS A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL IN LAKEVIEW, MICHIGAN, WITH 16 ACUTE-CARE BEDS AND 31 SKILLED-NURSING-FACILITY BEDS. SHK IS A REGIONAL HEALTH CENTER FOR PRIMARY AND SECONDARY CARE. SERVICES INCLUDE AROUND-THE-CLOCK EMERGENCY CARE, INPATIENT ACUTE CARE, OUTPATIENT SURGICAL CARE, OUTPATIENT PHYSICAL MEDICINE AND REHABILITATION. IN FISCAL YEAR 2012 THERE WERE 235 INPATIENT ADMISSIONS, 756 INPATIENT DAYS, 101 REHAB & NURSING CENTER ADMISSIONS, 10,007 REHAB & NURSING CENTER PATIENT DAYS, AND 8,854 EMERGENCY ROOM VISITS. SPECTRUM HEALTH KELSEY HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION. | Description |
| Total Program Service Expense | 15535107 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| 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 | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | 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 | false | 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 | false | 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 | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 173 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ryan K Johnson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6162256310 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S Bower | AddressLine1 |
| City | Greenville | City |
| State | MI | State |
| ZIP Code | 488382628 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| CHRISTINA FREESE-DECKER | |||||||||
| Director / President | 2.00 | X | X | 0 | 296269 | 98716 | |||
| DAVID MACK | |||||||||
| Chairman | 2.00 | X | X | 0 | 0 | 0 | |||
| LINDA BLANCHARD | |||||||||
| Secretary | 2.00 | X | X | 0 | 0 | 0 | |||
| WILLIAM HAM | |||||||||
| Treasurer | 2.00 | X | X | 0 | 0 | 0 | |||
| BENNETT WALSTATTER | |||||||||
| Director - Part Year | 2.00 | X | 0 | 303967 | 35636 | ||||
| DAVID DULL | |||||||||
| Director - Part Year | 2.00 | X | 0 | 478825 | 136520 | ||||
| DOMENICO AUSIELLO MD | |||||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||||
| FRANZ MOGDIS | |||||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||||
| GREGORY PAGE MD PHD | |||||||||
| Director - Part Year | 2.00 | X | 0 | 165978 | 23440 | ||||
| KEVIN O'CONNOR | |||||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||||
| MARC CHIRCOP | |||||||||
| Director | 2.00 | X | 0 | 496257 | 185237 | ||||
| PETER HAINES | |||||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||||
| STEVE BOWSER | |||||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||||
| TAD CHARLES SIMON | |||||||||
| Director | 2.00 | X | 0 | 0 | 0 | ||||
| DAVID OEHRING | |||||||||
| VP Finance - Part Year | 2.00 | X | 0 | 169089 | 30309 | ||||
| RYAN JOHNSON | |||||||||
| Interim VP - Finance | 2.00 | X | 0 | 120560 | 25520 | ||||
| BRIAN BRASSER | |||||||||
| Chief Nursing Ops | 2.00 | 0 | 165875 | 23011 | X | ||||
| PRISCILLA MAHAR | |||||||||
| Chief Clinical | 2.00 | 0 | 159321 | 25804 | X | ||||
| VICKI JENSEN | |||||||||
| Chief Human Resources | 2.00 | 0 | 151829 | 24802 | X | ||||
| LORY READ | |||||||||
| Physician | 50.00 | 185837 | 0 | 25010 | X | ||||
| MICHAEL BORGELD | |||||||||
| Physician | 50.00 | 207808 | 0 | 20653 | X | ||||
| PHILIP SCHUMACHER | |||||||||
| Physician | 50.00 | 224338 | 0 | 20713 | X | ||||
| STEVEN FAHLEN | |||||||||
| Physician | 50.00 | 267126 | 0 | 32579 | X | ||||
| TODD PRYOR | |||||||||
| Physician | 50.00 | 274236 | 0 | 18316 | X | ||||
| MARY ANNE JONES | |||||||||
| Former CFO | 0.00 | 0 | 183112 | 27716 | X | ||||
| PAUL BONIS | |||||||||
| Former President | 0.00 | 0 | 372913 | 114178 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1159344 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3063996 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 868162 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| INCREMEDICAL LLC | |||||
| 8259 WICKER AVE | ST JOHN | IN | 46373 | REHAB SERVICES | 391860 |
| HAR CONSULTING | |||||
| 975 SPAULDING AVE SE | ADA | MI | 49301 | CONSULTING | 106141 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 121676 | AllOtherContributions |
| Total Contributions | 121676 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | 16726347 | 16726347 | |
| CAFETERIA | 722212 | 29015 | $29,015 | |
| OTHER HOSPITAL OPERATING INCOME | 900099 | 68806 | 68806 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16824168 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 498 | TotalRevenueColumn |
| Exclusion | $498 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23404 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23404 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23404 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23404 | RelatedOrExemptFunctionIncome |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 827 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | -827 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -827 | TotalRevenueColumn |
| Related Or Exempt Function Income | -827 | RelatedOrExemptFunctionIncome |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16968919 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16817730 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $29,513 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7052763 | Total |
| Program Services | 6476926 | ProgramServices |
| Management And General | 575837 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229785 | Total |
| Program Services | 211024 | ProgramServices |
| Management And General | 18761 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1194771 | Total |
| Program Services | 1097222 | ProgramServices |
| Management And General | 97549 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 453308 | Total |
| Program Services | 416297 | ProgramServices |
| Management And General | 37011 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1121 | Total |
| Management And General | 1121 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 825344 | Total |
| Program Services | 778177 | ProgramServices |
| Management And General | 47167 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 323202 | Total |
| Program Services | 303751 | ProgramServices |
| Management And General | 19451 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7601 | Total |
| Program Services | 7601 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690704 | Total |
| Program Services | 665245 | ProgramServices |
| Management And General | 25459 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36168 | Total |
| Program Services | 32111 | ProgramServices |
| Management And General | 4057 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32739 | Total |
| Program Services | 16210 | ProgramServices |
| Management And General | 16529 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249679 | Total |
| Program Services | 212227 | ProgramServices |
| Management And General | 37452 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127293 | Total |
| Program Services | 108199 | ProgramServices |
| Management And General | 19094 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 1471428 | 1471428 | |
| MEDICAL SUPPLIES | 886032 | 877745 | 8287 |
| MEDICAID QUALITY ASSESSMENT TAX | 464088 | 464088 | |
| SHARED SERVICES | 2452479 | 2377956 | 74523 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71220 | Total |
| Program Services | 18900 | ProgramServices |
| Management And General | 52320 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16569725 | Total |
| Program Services | 15535107 | ProgramServices |
| Management And General | 1034618 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1095 | BOY |
| EOY | 1095 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 203 | BOY |
| EOY | 395 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 170000 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 954059 | BOY |
| EOY | 1297314 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67291 | BOY |
| EOY | 75169 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11231 | BOY |
| EOY | 44216 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7068071 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5291882 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1899429 | BOY |
| EOY | 1776189 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 42500 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1108676 | BOY |
| EOY | 1733231 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4041984 | BOY |
| EOY | 5140109 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53082 | BOY |
| EOY | 59224 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6556 | BOY |
| EOY | 60615 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1083544 | BOY |
| EOY | 1666379 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1143182 | BOY |
| EOY | 1786218 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2655189 | BOY |
| EOY | 3054384 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 243613 | BOY |
| EOY | 299507 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2898802 | BOY |
| EOY | 3353891 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4041984 | BOY |
| EOY | 5140109 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 399194 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 55895 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | false | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 | 143308 | OtherCostOrOtherBasis |
| Book Value | 143308 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3916966 | OtherCostOrOtherBasis |
| Depreciation | 2867635 | Depreciation |
| Book Value | 1049331 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 155895 | OtherCostOrOtherBasis |
| Depreciation | 78676 | Depreciation |
| Book Value | 77219 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2798124 | OtherCostOrOtherBasis |
| Depreciation | 2297825 | Depreciation |
| Book Value | 500299 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 53778 | OtherCostOrOtherBasis |
| Depreciation | 47746 | Depreciation |
| Book Value | 6032 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1776189 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| FAS 136 ASSETS | 299507 |
| DUE FROM AFFILIATES | 1433724 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1733231 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| THIRD PARTY PAYABLE | $1,544,370 |
| DUE TO AFFILIATES | $122,009 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1666379 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) FOOTNOTE | Identifier |
| Return Reference | PART X, LINE 2 | ReturnReference |
| Explanation | SPECTRUM HEALTH SYSTEM CONDUCTS AN ANALYSIS ANNUALLY TO DETERMINE THE ORGANIZATION'S LIABILITY WITH RESPECT TO UNCERTAIN TAX POSITIONS. FOR THE YEAR ENDED JUNE 30, 2012 IT WAS DETERMINED THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS TO DISCLOSE. AS SUCH, THERE WAS NO FOOTNOTE ADDED TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | 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 | 257081 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 257081 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01700 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3776040 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3434637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 341403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02260 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 4033121 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3434637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 598484 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03960 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 4033121 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3434637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 598484 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03960 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,471,428 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6541136 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6864952 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -323816 | 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 | SPECTRUM HEALTH KELSEY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 419 WASHINGTON AVE | AddressLine1 |
| City | LAKEVIEW | City |
| State | MI | State |
| ZIP Code | 48850 | 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 C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH REHAB AND NURSING CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 418 WASHINGTON AVE | AddressLine1 |
| City | LAKEVIEW | City |
| State | MI | State |
| ZIP Code | 48850 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | NURSING HOME | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Eligibility criteria for free or discounted care | Schedule H, Part I, Line 3c | THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE. |
| Community benefit report prepared by related organization | Schedule H, Part I, Line 6a | SPECTRUM HEALTH |
| RELATED ORGANIZATION INFORMATION | SCHEDULE H, PART I, LINE 6A | THE HEALTH SYSTEM PUBLISHES A CONSOLIDATED COMMUNITY BENEFIT REPORT ON ITS WEBSITE AT WWW.SPECTRUMHEALTH.ORG (CLICK THE LINK TITLED "ABOUT US"). IN ADDITION, THE HEALTH SYSTEM HOLDS AN ANNUAL MEETING TO THE PUBLIC TO DISCUSS ITS COMMUNITY COMMITMENTS. |
| Costing Methodology used to calculate financial assistance | Schedule H, Part I, Line 7 | THE ORGANIZATION CALCULATES AN OVERALL COST-TO-CHARGE RATIO DERIVED BY USING THE IRS WORKSHEET 2 FORMAT, RATIO OF PATIENT CARE COST-TO-CHARGES. ALL PATIENT SEGMENTS AND PAYERS ARE USED IN THE CALCULATION. |
| Bad Debt Expense excluded from financial assistance calculation | Schedule H, Part I, Line 7, column(f) | 1,471,428 |
| Bad debt expense - financial statement footnote | Schedule H, Part III, Line 4 | CONSOLIDATED FINANCIAL STATEMENT FOOTNOTE EXTRACT RELATED TO UNCOLLECTIBLE ACCOUNTS: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S 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. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE, PAYOR COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER AMOUNTS DUE FROM THIRD-PARTY PAYORS ARE SATISFIED, AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES. COSTING METHODOLOGY USED IN DETERMINING THE FIGURES REPORTED IN SCHEDULE H, PART III, SECTION A: ALL CHARGES ARE REPORTED AT GROSS, WHICH IS CONSISTENT WITH THE REPORTING METHODOLOGY USED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. RATIONALE FOR INCLUDING BAD DEBTS (AT GROSS CHARGES) IN SCHEDULE H, PART III, LINE 2: BAD DEBTS REPRESENT AN UNREIMBURSED LIABILITY TO THE ORGANIZATION AND FURTHER DEMONSTRATE HOW, BY ASSUMING THOSE COSTS, THE ORGANIZATION PROVIDES AND FULFILLS A HEALTH NEED IN THE COMMUNITY. IN ADDITION, EMERGENCY CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. SOME SERVICES ARE PROVIDED TO INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE BUT, FOR PERSONAL OR OTHER PRIVATE REASONS, DON'T APPLY FOR FINANCIAL ASSISTANCE. USING THIS INFORMATIONAL TAX RETURN FOR ITS INTENDED PURPOSE, THE ORGANIZATION CHOOSES TO BE FULLY TRANSPARENT AND SHARE ALL OF THE COSTS OF PROVIDING CHARITY CARE AND COMMUNITY BENEFITS TO THE COMMUNITIES WE SERVE, WHICH INCLUDES CHARITY CARE, THE COSTS OF FREE OR SUBSIDIZED COMMUNITY PROGRAMS, BAD DEBT EXPENSES AND SHORTFALLS IN GOVERNMENT REIMBURSEMENTS (MEDICARE AND MEDICAID). RATIONALE FOR REPORTING ZERO ON SCHEDULE H, PART III, LINE 3 (OR RATIONALE FOR EXCLUDING A PORTION OF BAD DEBT AMOUNTS AS COMMUNITY BENEFIT): THE ORGANIZATION HAS NOT IDENTIFIED THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES RELATES TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE (HAD THEY PROVIDED INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE), A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. THE ORGANIZATION IS IN THE PROCESS OF IMPLEMENTING A "PROPENSITY TO PAY" EVALUATION TOOL TO PROACTIVELY ASSESS PAYMENT RISK AND USE PREDICTIVE ANALYSIS TO DETERMINE A PATIENT'S LIKELIHOOD TO PAY MEDICAL BILLS. WITH THIS INFORMATION, THE ORGANIZATION WILL BE ABLE TO INITIATE MORE PRODUCTIVE FINANCIAL COUNSELING DISCUSSIONS WHICH WILL ULTIMATELY RESULT IN THE REDUCTION OF PATIENT BAD DEBT. |
| Community benefit & methodology for determining medicare costs | Schedule H, Part III, Line 8 | THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. IN DETERMINING MEDICARE SHORTFALLS THE ORGANIZATION USES A RATIO OF COST TO CHARGES. IN DETERMINING THE RATIO OF COST TO CHARGES THE ORGANIZATION ADJUSTS FOR BAD DEBT EXPENSES, NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES AND COMMUNITY BENEFITS ACCOUNTED FOR, AND OR REPORTED, ELSEWHERE. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES TO DETERMINE SHORTFALLS IN MEDICARE REIMBURSEMENTS. |
| Collection practices for patients eligible for financial assistance | Schedule H, Part III, Line 9b | THE ORGANIZATION'S COLLECTION POLICY THAT APPLIES TO THE LARGEST NUMBER OF ITS PATIENTS DURING THE TAX YEAR CONTAINS PROVISIONS TO ENSURE COLLECTION ACTIVITY OCCURS ONLY FOR THOSE WHO ARE UNWILLING TO PAY, OPPOSED TO THOSE NOT ABLE. PATIENTS EXPRESSING OR IDENTIFIED AS HAVING INABILITY TO PAY ARE ASSESSED FOR ASSISTANCE. |
| Used FPG to determine eligibility for providing discounted care criteria | Schedule H, Part V Section B, Line 10 | (1) SPECTRUM HEALTH KELSEY HOSPITAL - THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE.; |
| Other factors included in calculating amounts charges to patients | Schedule H, Part V Section B, Line 11h | (1) SPECTRUM HEALTH KELSEY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.; |
| Other ways hospital publicized Financial Assistance Policy | Schedule H, Part V Section B, Line 13g | (1) SPECTRUM HEALTH KELSEY HOSPITAL - THE ORGANIZATION PUBLICIZES THE FINANCIAL ASSISTANCE POLICY BY COMMUNICATING ITS AVAILABILITY VIA A PATIENT HANDBOOK, SIGNAGE, INFORMATIONAL BROCHURES, COMMUNITY PUBLICATIONS, AND VIA WORD OF MOUTH BY FINANCIAL COUNSELORS ASSISTING PATIENTS. ALTHOUGH THE POLICY ITSELF IS NOT PUBLICLY POSTED IN WAITING ROOMS OR ATTACHED TO BILLS, THERE IS REFERENCE THAT IT IS AVAILABLE. THE ORGANIZATION IS REVIEWING ITS POLICIES COMPARED TO THE REQUIREMENTS OF THE 501(R) PROPOSED REGULATIONS THAT WERE PUBLISHED ON JUNE 22, 2012.; |
| Means used to determine amounts billed | Schedule H, Part V Section B, Line 19d | (1) SPECTRUM HEALTH KELSEY HOSPITAL - THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO PATIENTS WHO QUALIFY FOR ASSISTANCE.; |
| Needs assessment. | Schedule H, Part VI, Line 2 | THE MONTCALM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS A SYSTEMATIC PROCESS FOR INVOLVING COMMUNITY PARTNERS IN EXAMINING INDICATORS OF HEALTH IN THE POPULATION, GATHERING INPUT FROM COMMUNITY MEMBERS IDENTIFYING STRATEGIC ISSUES, AND IDENTIFYING STRATEGIC PRIORITIES THAT, IF ADDRESSED, WOULD IMPROVE THE HEALTH OF MONTCALM COUNTY RESIDENTS. THE OVERALL OBJECTIVE OF THIS CHNA IS TO IDENTIFY KEY HEALTH AND HEALTH SERVICE ISSUES IN MONTCALM COUNTY. THE RESULTS WILL BE USED TO ASSIST IN PLANNING, IMPLEMENTATION OF PROGRAMS AND SERVICES, EVALUATING RESULTS, ALLOCATION OF RESOURCES, AND ACHIEVING IMPROVED HEALTH OUTCOMES, SPECIFICALLY RELATED TO IDENTIFIED NEEDS. MORE SPECIFICALLY, OBJECTIVES INCLUDE: * GAUGE THE OVERALL HEALTH CLIMATE OR LANDSCAPE IN MONTCALM COUNTY * DETERMINE POSITIVE AND NEGATIVE HEALTH INDICATORS * IDENTIFY RISK BEHAVIORS * ESTABLISH EXISTING CLINICAL PREVENTIVE PRACTICES * MEASURE THE PREVALENCE OF CHRONIC CONDITIONS * DETERMINE DEGREE/LEVEL OF HEALTH CARE ACCESS * ASCERTAIN BARRIERS AND OBSTACLES TO HEALTH CARE * UNCOVER GAPS IN HEALTH CARE SERVICES OR PROGRAMS * IDENTIFY HEALTH DISPARITIES |
| Patient education of eligibility for assistance. | Schedule H, Part VI, Line 3 | THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY THROUGH PRODUCING INFORMATION CARDS FOR THE UNINSURED, COMMUNITY OUTREACH PROGRAMS, CONSUMER INFORMATION CLASSES, ORGANIZATION WEBSITE, PERSONAL FINANCIAL COUNSELING, AND BY PROVIDING ASSISTANCE IN THE ACTUAL ENROLLMENT OF SUCH PROGRAMS. THE ORGANIZATION HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, THE ORGANIZATION ALSO PROACTIVELY IDENTIFIES PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE AND PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF THE NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, PATIENT CONCERNS THAT ARE RECEIVED AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. THE ORGANIZATION WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, VIA THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN EACH HOSPITAL DEPARTMENT, ADMISSIONS OFFICES AND OTHER PUBLIC LOCATIONS, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, THE ORGANIZATION LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH "FINANCIAL ASSISTANCE" AT WWW.SPECTRUMHEALTH.ORG). |
| Community information. | Schedule H, Part VI, Line 4 | THE TAXPAYER IS A CRITICAL ACCESS FACILITY THAT SERVES THE MEDICAL NEEDS OF THE RESIDENTS OF LAKEVIEW, MI AND THE FAR-NORTHERN PORTION OF A PRIMARY SERVICE AREA SHARED WITH UNITED MEMORIAL HOSPITAL, A RELATED ORGANIZATION. THE PRIMARY SERVICE AREA IS COMPRISED OF 19 ZIP CODES SURROUNDING LAKEVIEW, WHERE KELSEY HOSPITAL IS LOCATED, AND INCLUDES MONTCALM AND PORTIONS OF ADJACENT COUNTIES THAT SUPPORTS A POPULATION OF OVER 100,000 RESIDENTS. |
| Promotion of community health | Schedule H, Part VI, Line 5 | SPECTRUM HEALTH KELSEY'S BOARD OF DIRECTORS IS COMPOSED OF MEMBERS OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS. A MAJORITY OF THE BOARD RESIDES IN SPECTRUM HEALTH KELSEY'S PRIMARY SERVICE AREA. SPECTRUM HEALTH KELSEY ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PEOPLE THROUGHOUT THE COMMUNITY CAN COUNT ON SPECTRUM HEALTH KELSEY TO BE STANDING BY WITH EMERGENCY CARE 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD-CERTIFIED EMERGENCY CARE PHYSICIANS AND A NURSING STAFF THAT IS TRAINED AND EXPERIENCED IN EMERGENCY CARE. FURTHERMORE, NO PATIENT IS DENIED TREATMENT, REGARDLESS OF THEIR ABILITY TO PAY. |
| Affiliated health care system | Schedule H, Part VI, Line 6 | SPECTRUM HEALTH IS AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM IN WEST MICHIGAN OFFERING A FULL CONTINUUM OF CARE THROUGH THE SPECTRUM HEALTH HOSPITAL GROUP, WHICH IS COMPRISED OF NINE HOSPITALS INCLUDING HELEN DEVOS CHILDREN'S HOSPITAL, A STATE OF THE ART CHILDREN'S HOSPITAL THAT OPENED IN JANUARY 2011, AND 183 SERVICE SITES; THE SPECTRUM HEALTH MEDICAL GROUP AND WEST MICHIGAN HEART, PHYSICIAN GROUPS TOTALING MORE THAN 700 PROVIDERS; AND PRIORITY HEALTH, A HEALTH PLAN WITH 600,000 MEMBERS. SPECTRUM HEALTH IS WEST MICHIGAN'S LARGEST EMPLOYER WITH 19,000 EMPLOYEES. THE ORGANIZATION PROVIDED $204 MILLION IN COMMUNITY BENEFIT DURING ITS 2012 FISCAL YEAR. SPECTRUM HEALTH KELSEY IS A MEMBER OF THE AFFILIATED GROUP OF ENTITIES WITHIN THE SPECTRUM HEALTH SYSTEM ("SPECTRUM HEALTH"). EACH MEMBER CREATES VALUE WITHIN ITS RESPECTIVE COMMUNITY AND IS RESPONSIBLE FOR THEIR ACTIONS AND THE IMPACT THESE ACTIONS HAVE. FROM ITS INCEPTION, SPECTRUM HEALTH HAS BEEN A FAITHFUL STEWARD OF ITS COMMUNITY ASSETS. AS A WEST MICHIGAN-BASED NOT-FOR-PROFIT HEALTH SYSTEM, THE ORGANIZATION INVESTS ITS NET EARNINGS TO IMPROVE PATIENT CARE, BUILD AND RENOVATE FACILITIES, PURCHASE NEW TECHNOLOGY, PROVIDE HEALTH EDUCATION AND FUND LOCAL COMMUNITY PROGRAMS. OVER THE YEARS, OUR MISSION HAS REMAINED THE SAME-TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE TAKE OUR MISSION SERIOUSLY. IT IS CENTRAL TO OUR STRATEGIC DISCUSSIONS AND GUIDES OUR INVESTMENTS AND THE ALLOCATION OF OUR RESOURCES. SPECTRUM HEALTH IS COMMITTED TO PROVIDING VALUE TO THE PEOPLE WE SERVE. "VALUE" MEANS ACCESS TO HIGH-QUALITY HEALTH CARE AT AFFORDABLE COSTS, AS WELL AS ACCESS TO THE FULL CONTINUUM OF HEALTH CARE SERVICES, FROM HEALTH INSURANCE TO OUTPATIENT CARE TO INPATIENT AND HOME CARE, AND EVERYTHING IN BETWEEN. SPECTRUM HEALTH HAS HUNDREDS OF PROGRAMS THAT SUPPORT ITS MISSION "TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE." THESE PROGRAMS ARE BROUGHT TOGETHER UNDER NINE KEY AREAS: HEALTHIER COMMUNITIES, EDUCATION, COMMUNITY ENGAGEMENT, RESEARCH, INNOVATION, EMPLOYEE ENGAGEMENT, SUSTAINABILITY, REGIONAL RELATIONSHIPS AND COMMUNITY BENEFIT. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | 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 (16 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BENNETT WALSTATTER | |||||||||||||
| 0 | 290566 | 0 | 5000 | 0 | 8402 | 0 | 9800 | 0 | 25836 | 0 | 339604 | 0 | 0 |
| BRIAN BRASSER | |||||||||||||
| 0 | 139680 | 0 | 24528 | 0 | 1667 | 0 | 5852 | 0 | 17158 | 0 | 188886 | 0 | 0 |
| CHRISTINA FREESE-DECKER | |||||||||||||
| 0 | 217429 | 0 | 76813 | 0 | 2027 | 0 | 57363 | 0 | 41354 | 0 | 394985 | 0 | 31125 |
| DAVID DULL | |||||||||||||
| 0 | 346489 | 0 | 106463 | 0 | 25873 | 0 | 86165 | 0 | 50355 | 0 | 615345 | 0 | 39891 |
| DAVID OEHRING | |||||||||||||
| 0 | 140961 | 0 | 25223 | 0 | 2905 | 0 | 10615 | 0 | 19694 | 0 | 199398 | 0 | 0 |
| GREGORY PAGE MD PHD | |||||||||||||
| 0 | 100896 | 0 | 64247 | 0 | 835 | 0 | 7834 | 0 | 15606 | 0 | 189418 | 0 | 0 |
| LORY READ | |||||||||||||
| 155746 | 0 | 28824 | 0 | 1266 | 0 | 7342 | 0 | 17668 | 0 | 210847 | 0 | 0 | 0 |
| MARC CHIRCOP | |||||||||||||
| 0 | 377526 | 0 | 102560 | 0 | 16170 | 0 | 124745 | 0 | 60492 | 0 | 681494 | 0 | 0 |
| MARY ANNE JONES | |||||||||||||
| 0 | 175712 | 0 | 0 | 0 | 7400 | 0 | 8964 | 0 | 18752 | 0 | 210828 | 0 | 0 |
| MICHAEL BORGELD | |||||||||||||
| 174476 | 0 | 300 | 0 | 33031 | 0 | 1680 | 0 | 18972 | 0 | 228461 | 0 | 0 | 0 |
| PAUL BONIS | |||||||||||||
| 0 | 264136 | 0 | 105006 | 0 | 3771 | 0 | 67313 | 0 | 46865 | 0 | 487092 | 0 | 26824 |
| PHILIP SCHUMACHER | |||||||||||||
| 221328 | 0 | 150 | 0 | 2860 | 0 | 0 | 0 | 20713 | 0 | 245051 | 0 | 0 | 0 |
| PRISCILLA MAHAR | |||||||||||||
| 0 | 132940 | 0 | 23651 | 0 | 2730 | 0 | 5658 | 0 | 20146 | 0 | 185126 | 0 | 0 |
| STEVEN FAHLEN | |||||||||||||
| 262268 | 0 | 3175 | 0 | 1683 | 0 | 9800 | 0 | 22779 | 0 | 299704 | 0 | 0 | 0 |
| TODD PRYOR | |||||||||||||
| 273679 | 0 | 150 | 0 | 407 | 0 | 0 | 0 | 18316 | 0 | 292552 | 0 | 0 | 0 |
| VICKI JENSEN | |||||||||||||
| 0 | 126857 | 0 | 22611 | 0 | 2360 | 0 | 5407 | 0 | 19395 | 0 | 176630 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Arrangement used to establish the top management official's compensation | Schedule J, Part I, Line 3 | THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT SPECTRUM HEALTH KELSEY. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2012 (7/1/11-6/30/12), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS: * SULLIVAN, COTTER AND ASSOCIATES, INC.: 2011 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * INTEGRATED HEALTHCARE STRATEGIES: 2011 HEALTHCARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2011 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * TOWERS WATSON DATA SERVICES: 2011/2012 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT THESE SOURCES ARE CONSISTENT WITH THOSE USED IN LAST YEAR'S ANALYSIS. COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATE CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III). |
| Severance or change-of-control payment | Schedule J, Part I, Line 4a | $24,674 DAVID DULL |
| Supplemental nonqualified retirement plan | Schedule J, Part I, Line 4b | $ 31,125 CHRISTINA FREESE-DECKER $ 39,891 DAVID DULL $ 26,824 PAUL BONIS THIS QUESTION IS ANSWERED "YES" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, DO "PARTICIPATE IN" A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ENDOWMENT FUNDS | FORM 990, PART IV, LINE 10 | SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION (38-2990574) HOLDS AN UNRESTRICTED, BOARD DESIGNATED ENDOWMENT TO BE USED FOR THE BENEFIT OF SPECTRUM HEALTH UNITED (38-1358412), SPECTRUM HEALTH KELSEY (38-1297435), AMBULATORY UNITED (38-3170488), AND UNITED LIFESTYLES (38-3589727). THE ENDOWMENT FUND IS PROPERLY REPORTED ON SCHEDULE D, PART V OF SPECTRUM HEALTH UNITED MEMORIAL FOUNDATIONS FORM 990. |
| Significant changes to organizational documents | Form 990, Part VI, Section A, Line 4 | THE BYLAWS OF SPECTRUM HEALTH KELSEY WERE AMENDED TO ESTABLISH THE CREDENTIALING COMMITTEE, A STANDING COMMITTEE OF THE BOARD. THE CREDENTIALING COMMITTEE WAS ESTABLISHED TO CONSIDER AND ACT ON ALL REQUESTS FOR APPOINTMENT OR REAPPOINTMENT TO THE MEDICAL STAFF AND REQUESTS FOR CLINICAL PRIVILEDGES. THE AMENDED BYLAWS ALSO CLARIFIES THE DUTIES AND RESPONSIBILITIES OF THE CHAIRPERSON OF THE BOARD COMMITTEES. |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | THE ORGANIZATION HAS ONE MEMBER(S)/STOCKHOLDER(S) AS FOLLOWS: - SPECTRUM HEALTH UNITED (F/K/A UNITED MEMORIAL HOSPITAL ASSOCIATION) (EIN 38-1358412), A MICHIGAN NONPROFIT CORPORATION. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | THE SOLE MEMBER(S) (SEE FORM 990, PART VI, LINE 6) OF THE ORGANIZATION APPOINTS ALL MEMBERS OF THE BOARD OF DIRECTORS. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | UNLESS OTHERWISE NOTED BELOW, THE SOLE MEMBER(S) (SEE FORM 990, PART VI, LINE 6) OF THE ORGANIZATION HAS THE RESERVED POWERS SET FORTH BELOW, AND SHALL NOT BE DEEMED AUTHORIZED UNLESS AND UNTIL APPROVED BY THE SOLE MEMBER(S): -THE ADOPTION OF OR AMENDMENTS TO THE ARTICLES OF INCORPORATION AND/OR THE BYLAWS OF THE ORGANIZATION (THE "GOVERNING DOCUMENTS") OR ANY SUBSIDIARY OF THE ORGANIZATION; -THE ADOPTION OF OR AMENDMENT OF STRATEGIC PLANS, VISIONS, BUSINESS PLANS, JOINT VENTURES AND FACILITY MASTER PLANS; -THE ADOPTION OF OR AMENDMENT OF THE ANNUAL OPERATING AND CAPITAL BUDGETS; -APPROVAL OF CAPITAL EXPENDITURES PURSUANT TO GUIDELINES AS ADOPTED AND/OR REVISED BY UNITED FROM TIME TO TIME; -APPROVAL OF ALL BORROWING FOR CAPITAL OR OPERATING PURPOSES, ALL GUARANTEES OF INDEBTEDNESS, AND ALL MORTGAGES OF REAL ESTATE; -APPROVAL OF ALL PROJECTS REQUIRING A CERTIFICATE OF NEED UNDER MICHIGAN LAW; -APPROVAL OF THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF PROPERTY PURSUANT TO GUIDELINES AS ADOPTED AND/OR REVISED BY UNITED FROM TIME TO TIME; -APPROVAL OF THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION, OR THE DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR CHANGE IN CORPORATE MEMBERSHIP OF THE ORGANIZATION OR ANY SUBSIDIARY OF THE ORGANIZATION; OR -ANY OTHER APPROVAL OF UNITED REQUIRED BY LAW OR BY THE GOVERNING DOCUMENTS. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE REVIEW PROCESS FOR THIS FORM 990 IS AS FOLLOWS: 1. PREPARATION OF THE RETURN IS SUPERVISED AND REVIEWED BY THE ORGANIZATION'S CORPORATE TAX MANAGER. 2. A SECOND REVIEW IS PERFORMED BY AN EXTERNAL CPA FIRM WITH EXPERTISE IN TAX-EXEMPT RETURN PREPARATION. 3. THE RETURN IS REVIEWED BY THE ORGANIZATION'S FINANCE AND LEGAL DEPARTMENTS (INCLUDING THE VICE PRESIDENT OF FINANCE OR CHIEF FINANCIAL OFFICER) AND SHARED WITH THE MEMBERS OF THE BOARD OF DIRECTORS. 4. THE ORGANIZATION'S VICE PRESIDENT OF FINANCE OR CHIEF FINANCIAL OFFICER REVIEWS COMMENTS OR QUESTIONS RECEIVED BY MEMBERS OF THE BOARD OF DIRECTORS, IF ANY, TO ADDRESS OR TO INCORPORATE, AS APPROPRIATE, INTO THE RETURN PRIOR TO FILING. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | BOARD OF DIRECTORS 1.CONFLICTS OF INTEREST MUST BE DISCLOSED, BOTH VIA AN ANNUAL DISCLOSURE PROCESS AS WELL AS VERBALLY AT A BOARD MEETING PRIOR TO DISCUSSION OF ANY AGENDA ITEM WITH REGARD TO WHICH A BOARD MEMBER HAS A CONFLICT. 2.A PERSON HAVING A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT MAY MAKE A PRESENTATION AT A MEETING OF THE BOARD OF DIRECTORS OR COMMITTEE CONSIDERING THAT TRANSACTION OR ARRANGEMENT, BUT AFTER THAT PRESENTATION HE OR SHE SHALL LEAVE THE MEETING DURING DISCUSSION AND VOTING ON THAT PROPOSED TRANSACTION OR ARRANGEMENT. THE PERSON HAVING THE FINANCIAL INTEREST SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM IS PRESENT. 3.THE CHAIRPERSON OF THE BOARD OF DIRECTORS OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE (INCLUDING OUTSIDE ADVISORS) TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND TO ADVISE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN SPECTRUM HEALTH'S BEST INTEREST. 4.THE BOARD OF DIRECTORS OR COMMITTEE SHALL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER SPECTRUM HEALTH CAN, WITH REASONABLE EFFORTS, OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 5.IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OF DIRECTORS OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS AND MEMBERS WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN SPECTRUM HEALTH'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO SPECTRUM HEALTH, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 6.THE MINUTES OF THE MEETINGS OF THE BOARD OF DIRECTORS AND ALL SPECTRUM HEALTH COMMITTEES SHALL SET FORTH: A)THE NAMES OF THE PERSONS WHO DISCLOSED A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING SPECTRUM HEALTH OR ANY OF ITS SUBSIDIARIES AND THE NATURE OF THE FINANCIAL INTEREST; AND B)THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO SUCH TRANSACTION OR ARRANGEMENT, INCLUDING ANY DISCUSSION OF ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THAT MATTER. THE VOTES OF INDIVIDUAL MEMBERS NEED NOT BE RECORDED UNLESS OTHERWISE DIRECTED BY THE BOARD OF DIRECTORS OR COMMITTEE. MANAGEMENT 1. UPON ACCEPTANCE OF AN EMPLOYMENT OFFER, EACH MEMBER OF MANAGEMENT WILL COMPLETE A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE QUESTIONNAIRE IS SENT TO THE ORGANIZATION'S LEGAL DEPARTMENT AND IS ALSO MAINTAINED BY HUMAN RESOURCES IN THAT PERSON'S PERSONNEL FILE. 2. ANNUALLY, EACH MEMBER OF MANAGEMENT WILL COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE ELECTRONICALLY. THE DISCLOSURE QUESTIONNAIRE IS REVIEWED BY THE LEGAL AND ORGANIZATIONAL INTEGRITY DEPARTMENTS. 3. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF MANAGEMENT COMPLETE ANOTHER DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER EMPLOYMENT WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. IF A MEMBER OF MANAGEMENT COMPLETES A DISCLOSURE QUESTIONNAIRE AS A RESULT OF A NEW POTENTIAL CONFLICT OF INTEREST, THAT DISCLOSURE QUESTIONNAIRE IS SUBMITTED TO THE LEGAL AND ORGANIZATIONAL INTEGRITY DEPARTMENTS FOR REVIEW. 4. THE LEGAL AND ORGANIZATIONAL INTEGRITY DEPARTMENTS, IN CONSULTATION WITH EXECUTIVE MANAGEMENT, DETERMINE HOW ANY REPORTED CONFLICTS SHOULD BE MANAGED. MANAGEMENT OF A CONFLICT MAY TAKE A VARIETY OF DIFFERENT FORMS FROM IMPLEMENTATION OF A MANAGEMENT PLAN TO REQUIRING THAT THE MEMBER OF MANAGEMENT CEASE THE ACTIVITY CREATING THE CONFLICT OR, IN EXTREME CASES, LEAVE THE ORGANIZATION'S EMPLOYMENT. MANAGEMENT IS DETERMINED ON AN INDIVIDUAL BASIS BASED UPON THE FACTS AND CIRCUMSTANCES SURROUNDING THE DISCLOSURE. THE PURPOSE OF CONFLICT MANAGEMENT IS TO PROVIDE TRANSPARENCY WITHIN THE ORGANIZATION AND TO ENSURE THAT ORGANIZATION'S EMPLOYEES ARE ALWAYS ACTING IN THE BEST INTEREST OF ORGANIZATION. |
| Process used to establish compensation of top management official | Form 990, Part VI, Section B, Line 15a | THE SPECTRUM HEALTH SYSTEM BOARD OF DIRECTORS (THROUGH ITS EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF THE TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES AT SPECTRUM HEALTH KELSEY. LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED TO THE EXECUTIVE COMMITTEE IN ADVANCE OF MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2012 (7/1/11-6/30/12), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS: * SULLIVAN, COTTER AND ASSOCIATES, INC.: 2011 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * INTEGRATED HEALTHCARE STRATEGIES: 2011 HEALTHCARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2011 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * TOWERS WATSON DATA SERVICES: 2011/2012 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT THESE SOURCES ARE CONSISTENT WITH THOSE USED IN LAST YEAR'S ANALYSIS. COMPENSATION ADJUSTMENTS ARE APPROVED BY EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE IS NATIONAL AND REFLECTS THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATE CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND COMPLYING WITH THE POTENTIAL SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III). |
| Process used to establish compensation of other officers/key employees | Form 990, Part VI, Section B, Line 15b | SEE EXPLANATION PROVIDED FOR FORM 990, PART VI, LINE 15A. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION HAVE BEEN PROVIDED TO THE STATE OF MICHIGAN AND ARE AVAILABLE TO THE PUBLIC ON THE STATE'S WEBSITE. THE ORGANIZATION'S BYLAWS AND INTERNAL POLICIES ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. THE OVERALL SYSTEM CONSOLIDATED FINANCIAL STATEMENTS ARE PROVIDED AT WWW.SPECTRUMHEALTH.ORG IN THE SECTION TITLED "ABOUT US." FINANCIAL PERFORMANCE IS DISCUSSED AT AN ANNUAL PUBLIC MEETING HELD AND POSTED TO WWW.SPECTRUMHEALTH.ORG ANNUALLY (UNDER THE SECTION TITLED "ABOUT US"). |
| Average number of hours devoted per week to related organization | Form 990, Part VII, Section A, Column B | CHRISTINA FREESE-DECKER - 48 DAVID MACK - 4 LINDA BLANCHARD - 2 WILLIAM HAM - 4 BENNETT WALSTATTER - 48 DAVID DULL - 48 DOMENICO AUSIELLO, MD - 4 FRANZ MOGDIS - 4 GREGORY PAGE, MD, PHD - 48 KEVIN O'CONNOR - 2 MARC CHIRCOP - 50 PETER HAINES - 4 STEVE BOWSER - 2 TAD (CHARLES) SIMON - 2 DAVID OEHRING - 48 RYAN JOHNSON - 48 BRIAN BRASSER - 48 PRISCILLA MAHAR - 48 VICKI JENSEN - 48 MARY ANNE JONES - 50 PAUL BONIS - 50 |
| COMPENSATION | FORM 990, PART VII, SECTION A, LINE 1A | CONSISTENT WITH PRIOR YEARS, THE COMPENSATION REPORTED FOR THESE INDIVIDUALS IS NOT FOR SERVICES IN THEIR CAPACITY AS MEMBERS OF THE BOARD OF DIRECTORS BUT FOR SERVICES AS EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION. CONSISTENT WITH PRIOR YEARS, COMPENSATION AND BENEFITS ARE REPORTED USING THE MOST RECENT CALENDAR YEAR COMPENSATION DATA. THE COMPENSATION FIGURES REPORTED IN THESE SECTIONS IS FOR THE YEAR ENDED DECEMBER 31, 2011. INDIVIDUALS WITH COMPENSATION REPORTED IN PART VII WORK A COMBINED AVERAGE OF 50 HOURS PER WEEK FOR THE REPORTING ORGANIZATION AND/OR A RELATED TAX-EXEMPT ORGANIZATION. |
| Other changes in net assets or fund balances | Form 990, Part XI, Line 5 | FAS 136 ACTIVITY - 55895; |
| OVERSIGHT OF THE AUDIT | FORM 990, PART XII, LINE 2C | THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION WERE AUDITED BY AN INDEPENDENT AUDITOR AS PART OF THE CONSOLIDATED AUDIT OF SPECTRUM HEALTH SYSTEM (EIN 38-3382353). THE OVERSIGHT OF THAT AUDIT IS BEING ASSUMED BY SPECTRUM HEALTH SYSTEM. |
| IRS TAX FILLINGS | FORM 990, PART V, LINE 1A, 2A, AND PART VII, SECTION B, LINE 2 | SPECTRUM HEALTH UNITED (38-1358412), THE SOLE MEMBER OF SPECTRUM HEALTH KELSEY, FILES ALL APPLICABLE IRS TAX FILINGS, INCLUDING FORMS 1099, 1096, W-2, AND W-3 ON BEHALF OF SPECTRUM HEALTH KELSEY. FOR PURPOSES OF COMPLETING FORM 990, PART V, LINE 1A AND 2A REPRESENTS THE THE 1099'S AND W-2'S ALLOCABLE TO THE ACTIVITIES OF SPECTRUM HEALTH KELSEY. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| SPECTRUM HEALTH SYSTEM | ||||||||||
| 100 MICHIGAN ST NE | GRAND RAPIDS | MI | 49503 | 383382353 | MANAGEMENT | MI | 501(C)(3) | 11 - Type III - FI | NA | false |
| SH UNITED MEMORIAL FOUNDATION | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 382990574 | PHILANTHRO | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH UNITED | false |
| AMBULATORY UNITED | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 383170488 | HEALTHCARE | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH UNITED | false |
| UNITED LIFESTYLES | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 383589727 | WELLNESS | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH UNITED | false |
| SPECTRUM HEALTH UNITED | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 381358412 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTCALM PRIMARY CARE PHYSICIANS | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S BOWER | AddressLine1 |
| City | GREENVILLE | City |
| State | MI | State |
| ZIP Code | 48838 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202544762 | EIN |
| Primary Activity | MED. SVCS | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH UNITED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORPORATION | TypeOfEntity |
| Percentage Ownership | 1 | PercentageOwnership |
| 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 |
| 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 | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SECTION 512(B)(13) CONTROLLED ENTITY? | Identifier |
| Return Reference | PART II, COLUMN (G) | ReturnReference |
| Explanation | THE ORGANIZATION IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, SPECTRUM HEALTH SYSTEM. | Explanation |
Comments