2013-11-06T13:46:33-05:00 2012-12-31 990 2012-01-01 383426063 CARO COMMUNITY HOSPITAL CARO 401 N HOOPER ST PO BOX 435 CARO MI 48723 MARC AUGSBURGER 9896733141 2013-11-04 2012 2016-03-07 17:11:31Z WILLIAM P MILLER 11802021 false X WWW.CCH-MI.ORG X 1999 MI CARO COMMUNITY HOSPITAL, A COMMUNITY-MINDED HEALTHCARE SYSTEM, IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE. 8 6 167 50 0 0 11012 116290 12380423 11472060 94093 37037 108984 137994 12594512 11763381 0 0 7548067 6690544 0 0 5511652 4731023 13059719 11421567 -465207 341814 6733270 7327985 3830419 4033856 2902851 3294129 CARO COMMUNITY HOSPITAL, A COMMUNITY-MINDED HEALTHCARE SYSTEM, IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE. false false 8518506 PROVISION OF NEEDED MEDICAL SERVICES TO THE COMMUNITY. 8518506 true false false false false false false false false true false false true true false false false false false false false false false false false true true false false true false false false true false false false true false false false false false true false false false false true 32 0 true 167 true false false false false false false false false false false false false X 8 6 false false false false false false false true true false false true true true true false false true false false MI X X RONALD D SREBINSKI CFO 9896733141 401 N HOOPER ST PO BOX 435 Caro MI 487230435 DALE PERZ 16.00 X X 45225 0 0 DAN BRISTOL 2.00 X X 0 0 0 DR AFONSO FERREIRA 2.00 X 0 0 0 LYNN LAETHEM 2.00 X X 0 0 0 RAYMOND BATES 2.00 X 0 0 0 RICK FULTON 2.00 X 0 0 0 RUBY REID 2.00 X 0 3080 0 WILLIAM P MILLER 40.00 X X X X 150536 0 30681 DR JULIE SAWADE 40.00 X 149518 0 14431 RONALD D SREBINSKI 40.00 X 102394 0 11323 SUE MORRIS 40.00 X 110645 0 14963 558318 3080 71398 4 false true false HOSPITAL MD 200 W PARK DRIVE STE 325 PEACHTREE CITY GA 30269 E R PHYSICIANS 760000 1 116290 116290 NET PATIENT SERVICE REV 900099 11472060 11472060 11472060 37037 37037 34085 38592 -4507 -4507 -4507 6856 48 6808 6808 CAFETERIA 722210 11628 11628 HPSA PAYMENTS 900099 6937 6937 117128 117128 135693 11763381 11647091 0 0 340159 340159 4484163 3466945 1017218 146503 113689 32814 1366660 1024494 342166 353059 258423 94636 121953 121953 15000 15000 987725 1021450 -33725 35729 35729 37174 40 37134 538817 486609 52208 19473 11464 8009 133262 133262 561797 392709 169088 83672 83672 SUPPLY COSTS 1259421 1215852 43569 DUES AND SUBSCRIPTIONS 114373 9879 104494 State of Michigan QAAP TAX 337840 337840 PURCHASED SERVICES 466050 300018 166032 18737 18737 11421567 8518506 2903061 0 258998 1384529 849601 804695 335499 284688 50424 36426 12291497 8000793 4761269 4290704 477479 526943 6733270 7327985 1046855 436770 386704 2090495 1643908 693069 1566474 3830419 4033856 X 2902851 3294129 2902851 3294129 6733270 7327985 X 341814 49464 X false true X true false X 133521 133521 5564246 2600792 2963454 12112 11227 885 6581618 5388774 1192844 4290704 INT IN CCH ENDOWMENT FOUNDATIO 526943 ASSETS LIMITED AS TO USE 526943 ACCOUNT PAYABLE TO THIRD PARTI 911600 ACCRUED AND OTHER LIABILITIES 654874 1566474 D9 Other revenues non included on Form 990 Part XI line 2d EXPENSES RELATING TO RENTAL COST OFFSET $38592 ON LINE 6B PART VIII EXPENSES RELATING TO AUXILIARY GIFT SHOP OFFSET $48 ON LINE 10B PART VIII D10 Other revenues included on Form 990 Part XI line 4b INTEREST INCOME $37037 CONTRIBUTIONS $116290 D11 Other expenses not included on Form 990 Part XII line 2d EXPENSES RELATING TO RENTAL COST OFFSET $38592 true true true X true X true true false false 11004 11004 1893130 963628 929502 1904134 963628 940506 161910 100 161810 161910 100 161810 2066044 963728 1102316 true 608471 154710 4593867 4593867 X true true 1 1 CARO COMMUNITY HOSPITAL

401 N HOOPER STREET PO BOX 43 CARO MI 487230435

X X X X 1 CARO COMMUNITY HOSPITAL 1 false true true 1.5000 true 2.50000 true X true true X X false X X true X X X X true X false false H01 Other charity care criteria description Part I line 3c THE HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CHARITY CARE SERVICES. H02 Related organization annual community benefit report Part I line 6a THE ANNUAL COMMUNITY BENEFIT AMOUNT RELATES TO THE VALUE OF SALARIES AND FRINGE BENEFITS OF THE HOSPITAL HEALTH SERVIVES DEPARTMENT WHICH PROVIDES SPECIALITY PHYSICIANS TO THE CARO COMMUNITY BY RENTING CLINIC SPACE AND PROVIDE RECEPTIONIST SERVICE TO THE PATIENTS OF TUSCOLA COUNTY AREA WHO WOULD HAVE TO DRIVE 35 TO 50 MILES OR EVEN TAKE THE DAY OFF FROM WORK TO RECEIVE ROUTINE SPECIALIST PHYSICIAN SERVICES. $153,185. ALSO THE COMMUNITY BENEFIT COST ASSOCIATED WITH PARTICIPATING IN BLOOD DRIVES, DOING SPORTS PHYSICALS,COMMUNITY CRAFT PROGRAMS, SENIOR FAIRS, HEALTH EVENTS AT THE FAIR,HOSPITAL AND AROUND THE CARO AREA IS $7,288. TOTAL COOMUNITY BENEFIT VALUE IS $160,473. H03 Bad debt description footnote Part III line 4 MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED UPON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. THE HOSPITAL COST TO CHARGE RATIO IS UTILIZED IN DETERMINING THE COST OF BAD DEBTS. BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 THAT IS REMOVED FOR PURPOSES OF SCHEDULE H LINE 7 COLUMN F IS $990511. COST OF THE NET BAD DEBT EXPENSE IS $608471. THEREFORE THE COST AT 61.43% H04 Subsidized health services costs Part I line 7g N/A H05 Debt expense included Part I line 7 col f N/A H06 Costing methodology explanation Part I line 7 THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO INDIVIDUALS THAT MAY QUALIFY FOR CHARITY CARE WAS CALCULATED BASED UPON THE AMOUNT OF SELF PAY EMERGENCY ROOM PATIENT CHARGES TIMES 20%, WHICH IS THE AMOUNT THAT PATIENTS WOULD QUALIFY FOR A DISCOUNT. THE BALANCE OF THE PATIENT ACCOUNTS WOULD THEN BE SUBJECTED TO CHARITY CARE GUIDELINES OF EARNINGS OF 200% OR LESS OF THE FEDERAL POVERTY GUIDELINES. $154710. THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN LINES 7(A)-(D) IS BASED ON THE COST-TO-CHARGE RATIOS. LINES 7(E)-(I) IS BASED ON ACTUAL COST. H07 Collection practices Part III line 9b IF THE PATIENT IS NOT ABLE TO MAKE PAYMENT ARRANGEMENTS, THE STAFF WILL VERBALLY DETERMINE IF THE PATIENT IS POTENTIALLY ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL CHARITY CARE POLICY. PATIENTS WHO APPEAR TO MEET THE CARO COMMUNITY HOSPITAL CRITERIA ARE REFERRED TO THE SOCIAL WORKER FOR FURTHER REVIEW IN ACCORDANCE WITH THE HOSPITAL CHARITY CARE POLICY. H08 Needs assessment Part VI question 2 ORGANIZATION COMMUNICATED WITH STATE AND LOCAL AGENCIES TO DETERMINE THE HEALTHCARE NEEDS OF THE COMMUNITY. EXAMPLES OF SERVICES PROVIDED BASED ON COMMUNITY NEEDS ARE IMMUNIZATIONS, VACCINES, SPORTS PHYSICALS, SENIOR AND HEALTH FAIRS, FIRST AID BOOTH, AND DIABETIC CLASSES. CARO COMMUNITY HOSPITAL HAS CURRENTLY JOINED THE MICHIGAN RURAL HEALTH GROUP WHO WILL CONDUCT THE COMMUNTY HEALTH NEEDS ASSESSMENT FOR THE HOSPITAL IN 2013. THE HEALTH NEEDS ASSESSMENT IS NOT DUE UNTIL 2013 AND IS CURRENTLY IN PROCESS. H09 Patient education Part VI question 3 EVERY UNINSURED PATIENT THAT IS AN INPATIENT, OUTPATIENT, SURGICAL, OBSERVATION, OR INCURS MORE THAN $5000 IN MEDICAL EXPENSES, RECEIVES A CHARITY CARE PACKAGE. THE PACKAGE INCLUDES A CHARITY CARE AND MEDICAID APPLICATION AND A HUMAN SERVICES REFERRAL FORM. ALL OTHER NON-INSURED PATIENTS MAY REQUEST A CHARITY CARE APPLICATION AT ANY TIME. H10 Community information Part VI question 4 ORGANIZATION IS LOCATED IN TUSCOLA COUNTY WHICH HAS A POPULATION OF APPROX. 56000, CARO HAS A POPULATION OF APPROX. 4200. TUSCOLA COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES. THE UNEMPLOYMENT RATE IN TUSCLOA COUNTY IS HIGH BECAUSE OF THE LOSS OF MANY SMALL AUTOMOTIVE RELATED JOBS AND IS AT OR ABOVE THE STATE OF MICHIGAN9S UNEMPLOYMENT RATE. H11 Promoting community health Part VI question 5 ORGAINZATION PROVIDES SPECIAL CLINICS IN CARO SO PATIENTS DO NOT HAVE TO COMMUTE. H12 Affiliated health care system Part VI question 6 NA H13 State filings Part VI question 7 NA TILL 2013 H14 Eligible patients billed Part V question 21 All patients are elgible for financial assistance of an extented payment plan depending on the dollar amount of the bill owed. In 2012 emergent patients without any type of coverage were also extended a 20% discount plus offered an extended payment plan if needed. The discount plan established in 2012 was based on the average total commercial coverage and one goverment plan which was workers compensation and the average came to 20% dicounted. X X false false false false false false false false false WILLIAM P MILLER 150536 30681 181217 DR JULIE SAWADE 149518 14431 163949 CCH ENDOWMENT FOUNDATION LOAN FOR DIGITAL MAM 136835 101134 false true true 101134 DALE PERZ - PERZPECTIVES BOARD MEMBER 45225 MARKETING SERVICES false O01 Form 990 governing body review Part VI line 11 EACH BOARD MEMBER WILL RECEIVE A COMPLETE COPY OF THE RETURN. THE CEO AND CFO WILL REVIEW THE RETURN DURING THE NOVEMBER MEETING OF THE BOARD OF TRUSTEES. O02 Conflict of interest policy compliance Part VI line 12c THE CONFLICT OF INTEREST POLICY IS MONITORED THROUGH DISCUSSION WITH THE CEO AND EACH BOARD MEMBER. O03 CEO executive director top management comp Part VI line 15a THE BOARD UTILIZES THE MICHIGAN HEALTH AND HOSPITAL ANNUAL SURVEY TO DETERMINE THE COMPENSATION LEVEL FOR THE CEO. O04 Governing documents etc available to public Part VI line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC. O05 Explanation of other changes in net assets or fund balances Part XI line 9 CCH FOUNDATION $0 donation for 2012 NET CHANGE IN CCH ENDOWMENT FOUNDATION $49464 CCH HEALTH CARE ALLIANCE 401 N HOOPER ST CARO MI 487230435 383426058 PARENT TO CCH MI 501C3 III-F1 N/A false CCH ENDOWMENT FOUNDATION 401 N HOOPER ST CARO MI 487230435 382422995 FOUNDATION MI 501C3 III-F1 N/A false