2013-08-13T13:37:39-05:00 2012-09-30 BKD LLP 200 E Main St Suite 700 Fort Wayne IN 46802 990 2011-10-01 352362438 STURGIS HOSPITAL INC % ROBERT J LABARGE STUR 2696594400 916 MYRTLE AVENUE STURGIS MI 49091 ROBERT J LABARGE 2013-08-15 true Joyce A Dulworth 2604604000 2011 2016-02-25 16:41:14Z ROBERT J LABARGE 916 MYRTLE AVENUE STURGIS MI 49091 43983141 false X WWW.STURGISHOSPITAL.COM X 2009 MI STURGIS HOSPITAL IS AN 84-BED LICENSED, ACUTE CARE FACILITY SERVING A POPULATION OF APPROXIMATELY 50,000 PEOPLE. STURGIS HOSPITAL, INC EXISTS TO ENSURE THAT THE COMMUNITY HAS ADEQUATE ACCESS TO HEALTHCARE. 12 11 418 0 0 0 466484 86876 42576586 43418062 13825 17323 346678 172991 43403573 43695252 0 0 0 0 22235964 22516038 0 0 0 21449641 23036688 43685605 45552726 -282032 -1857474 35489638 34602810 17560469 18062773 17929169 16540037 X STURGIS HOSPITAL INC. IS COMMITTED TO THE PROVISION OF THE HIGHEST QUALITY PRIMARY AND SECONDARY HEALTHCARE TO THE COMMUNITY WE SERVE. STURGIS HOSPITAL INC. STRIVES, IN ALL CIRCUMSTANCES TO PROVIDE ACUTE AND PREVENTATIVE CARE THAT IS CONSISTENT WITH THE VALUES AND NEEDS OF THE UNIQUE SEGMENTS OF OUR POPULATION. BY EXCERCISING RESPONSIBLE STEWARDSHIP OF OUR RESOURCES, STURGIS HOSPITAL INC. WILL ALSO ENDEAVOR TO MAXIMIZE THE BREADTH AND DEPTH OF CARE PROVIDED TO OUR COMMUNITY. false false 38124663 43593261 STURGIS HOSPITAL IS A 84-BED LICENSED, ACUTE CARE FACILITY. NEARLY 40 ACTIVE MEDICAL STAFF MEMBERS, AVAILABLE WITHIN THE STURGIS AND SURROUNDING COMMUNITIES, REPRESENT A WIDE VARIETY OF SPECIALTIES INCLUDING ANESTHESIOLOGY, FAMILY PRACTICE, GENERAL SURGERY, GYNECOLOGY, INTERNAL MEDICINE, OBSTETRICS, OPHTHALMOLOGY, ORTHOPAEDICS, PATHOLOGY, PEDIATRICS, PODIATRY, RADIOLOGY, UROLOGY AND VASCULAR SURGERY. ADDITIONAL SPECIALTIES ARE OFFERED THROUGH THE HOSPITAL'S COURTESY, CONSULTING AND AFFILIATE MEDICAL STAFFMEMBERS. THESE SERVICES INCLUDE CARDIOLOGY, NEUROLOGY, NEUROSURGERY, ONCOLOGY, AND PULMONARY MEDICINE. MEDICAL/SURGICAL CARE IS OFFERED ON AN INPATIENT AND OUTPATIENT LEVEL. BOTH LASER AND LAPAROSCOPIC PROCEDURES ARE PERFORMED IN THE HOSPITAL'S THREE ROOM SURGICAL SUITE. A FOUR-BED CORONARY/INTENSIVE CARE UNIT IS ALSO AVAILABLE FOR CRITICAL PATIENTS. THE 12-BED OBSTETRICAL DEPARTMENT OFFERS LABOR/DELIVERY/RECOVERY/POSTPARTUM ROOMS FOR THE EXPECTANT MOM AND HER FAMILY. EMERGENCY SERVICES ARE AVAILABLE 24 HOURS A DAY, 365 DAYS A YEAR, WITH FULL-TIME MEDICAL STAFF COVERAGE. CARDIAC REHABILITATION AND PHYSICAL THERAPY PROGRAMS AS WELL AS COMMUNITY EDUCATION PROGRAMS DESIGNED TO HELP OUR COMMUNITY LEAD A HEALTHIER LIFESTYLE, ARE ALSO AVAILABLE. STURGIS HOSPITAL HAS A COMMITMENT TO MAINTAIN STATE-OF-THE-ART DIAGNOSTIC TECHNOLOGY, WHICH INCLUDES ANGIOGRAPHY, 64-SLICE CT SCANNING, MAMMOGRAPHY, MOBILE MRI, A SLEEP DISORDER LABORATORY AND SPECT IMAGING AND ULTRASOUND. STURGIS HOME HEALTH CARE--A TOP 500 AGENCY IN THE NATION--IS A DIVISION OF STURGIS HOSPITAL. IT WORKS CLOSELY WITH PHYSICIANS TO PROVIDE QUALITY HOME HEALTH CARE SERVICES FOLLOWING DISCHARGE FROM A HOSPITAL OR FOR THOSE WITH SPECIAL MEDICAL NEEDS THAT DO NOT REQUIRE HOSPITALIZATION. THESE SERVICES INCLUDE NURSING ASSISTANCE, AIDS, COMPANIONS, PHYSICAL, OCCUPATIONAL, SPEECH AND LANGUAGE THERAPIES, AS WELL AS A MEDICAL SOCIAL WORKER. HOSPICE OF STURGIS PROVIDES SUPPORT AND CARE FOR PERSONS IN THE LAST PHASES OF AN INCURABLE DISEASE. THESE SERVICES CAN BE PROVIDED IN A PATIENT'S HOME, NURSING HOME OR ADULT FOSTER CARE SETTING. THE HOSPICE TEAM INCLUDES PHYSICIANS, NURSES, THERAPISTS,AIDES, SOCIAL WORKERS, NUTRITIONISTS, VOLUNTEERS AND CLERGY, AS WELL AS BEREAVEMENT AND SUPPORT GROUPS. 38124663 true true false false false false false false false false true false true true false false true false false false false false false false true false true true false false true true false false false false false false false false false false false false false false false false false false false true 100 0 418 true false false false false false false false false false false X 12 11 false true false false false false false true true false false true true true true true true true true true false X ROBERT J LABARGE 2696594400 916 MYRTLE AVENUE STURGIS MI 49091 KEYER PATEL 40.0 X X 525591 0 34103 JOSE ALBARRAN 1.0 X 0 0 0 JEANNIE GERCHOW 1.0 X 0 0 0 P JOSEPH HAAS JR 1.0 X 0 0 0 MEREDITH HUNT 1.0 X 0 0 0 FLOYD KUNCE 1.0 X X 0 0 0 DAVID LOCEY 1.0 X 0 0 0 JOHN MAYER 1.0 X X 0 0 0 ERIC WYNES 1.0 X 0 0 0 THOMAS ROCK 1.0 X 0 0 0 BHARAT VAKHARIA MD 1.0 X 0 0 0 PHILIP WARD 1.0 X X 0 0 0 SHARI RANSBERGER 40.0 X 94845 0 19602 JOSEPHINE IDEN - HIRED 092011 40.0 X 20353 0 2102 CHARLOTTE PAVILANIS 40.0 X 60268 0 606 MARY KAY SCHULTZ 40.0 X 97789 0 16533 ASHISH VERMA 40.0 X 445626 0 37232 WILSON SAWA 40.0 X 287335 0 37232 JAMES GRANNELL 40.0 X 444632 0 39603 ELIEZER MELENDEZ 40.0 X 438851 0 42732 DAVID SARACENO 40.0 X 221537 0 14238 2636827 0 243983 12 false true false QUORUM HEALTH RESOURCES PO BOX 305172 NASHVILLE TN 37230 MANAGEMENT 795205 PT SERVICES REHABILITATION PO BOX 833 TIFFIN OH 44883 REHAB SERVICES 528605 SOUTH BEND MEDICAL FOUNDATION PO BOX 2030 MISHAWAKA IN 46546 LAB SERVICES 450514 ALLIANCE-HNI LLC 7647 COLLECTION CENTER DRIVE CHICAGO IL 60693 MRI SERVICES 450275 SODEXO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY MAINT, MGMT 409794 13 14670 72206 86876 INPATIENT REVENUE 900099 17945530 17945530 OUTPATIENT REVENUE 900099 14394575 14394575 PHYSICIAN OFFICE REVENUE 900099 10772615 10772615 CAFETERIA REVENUE 900099 89255 89255 OTHER REVENUE 900099 216087 216087 43418062 17323 17323 0 0 455678 280479 175199 175199 175199 0 5202 14670 7410 -2208 -2208 0 0 0 43695252 43593261 15115 0 0 0 0 2880809 2304647 576162 0 15201457 12161166 3040291 127580 102064 25516 2989797 2391838 597959 1316395 1053116 263279 267469 213975 53494 134916 107933 26983 74085 59268 14817 0 0 0 5473828 4379062 1094766 203016 162413 40603 5692806 4554245 1138561 255160 204128 51032 0 1657377 1491639 165738 49804 39843 9961 0 95657 76526 19131 616350 554715 61635 0 1879353 1691418 187935 75904 68314 7590 MEDICAL SUPPLIES 1344959 1344959 BAD DEBT 4952956 4952956 0 MISCELLANEOUS EXPENSE 263048 210438 52610 45552726 38124663 7428063 0 650 650 2122270 1719010 0 0 5972542 5814639 0 0 0 0 0 0 825063 824204 747426 390280 47803854 29266454 19550611 18537400 0 0 0 0 1773908 1848088 0 0 4497168 5468539 35489638 34602810 4062326 4993823 0 0 0 0 11956055 11655656 0 0 0 0 1542088 1413294 0 0 0 0 17560469 18062773 X 17902398 16497485 26771 42552 0 0 17929169 16540037 35489638 34602810 X -1857474 468342 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 109943 109943 28366153 12003890 16362263 18819708 16981368 1838340 508050 281196 226854 18537400 0 PENSION ASSET 2796299 DEFERRED FINANCING COSTS 276078 DUE FROM THIRD PARTY PAYERS 2396162 5468539 43695252 45552726 -1857474 82000 386342 468342 -1389132 39112185 82000 287889 369889 38742296 4952956 4952956 43695252 40887659 287889 287889 40599770 4952956 4952956 45552726 ASC 740 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. RECONCILIATION PART XI, LINE 8 CHANGE IN DEFINED BENEFIT PENSION PLAN GAINS $386,342 PART XII, LINE 2D RENTAL EXPENSE $280,479 SPECIAL EVENTS EXPENSE 7,410 TOTAL: $287,889 PART XII, LINE 4B BAD DEBT EXPENSE $4,952,956 PART XIII, LINE 2D RENTAL EXPENSE $280,479 SPECIAL EVENTS EXPENSE 7,410 TOTAL: $287,889 PART XIII, LINE 4B BAD DEBT EXPENSE $4,952,956 CHEF COOK-OFF 19872 14670 5202 7410 0 19872 14670 5202 7410 7410 -2208 true true true X true X true true true false true true 1 1564080 1563716 0.03850 1 7866606 6678301 1188305 0.02930 2 9430686 6678301 2752021 0.06780 23693 820 22873 0.00060 23693 820 22873 0.00060 2 9454379 6679121 2774894 0.06840 true 4952956 2287374 11077647 10973436 104211 X true true 1 1 STURGIS HOSPITAL

916 MYRTLE AVENUE STURGIS MI 49091

X X X STURGIS HOSPITAL 1 true true 200. true 200. true X X X X X true true X X X X true false true X false false PART I STURGIS HOSPITAL ACKNOWLEDGES THAT ALL INDIVIDUALS ARE NOT EQUALLY CAPABLE OF WITHSTANDING THE BURDEN OF PAYMENT FOR HEALTHCARE SERVICES.THE HOSPITAL PROVIDES AND PROMOTES ACCESS TO EMERGENCY AND MEDICALLY NECESSARY SERVICES WITHOUT REGARD TO ABILITY TO PAY. LINE 3C ACCORDING TO THE HOSPITAL'S EXISTING PUBLIC POLICY, ALL PATIENTS RECEIVING MEDICALLY NECESSARY SERVICES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE NEED OF THE PATIENTS, LACK OF EXISTING INSURANCE, AND OTHER RESOURCES REQUIRED FOR PAYMENT. ELIGIBILITY CRITERIA IS FURTHER BASED ON THE FEDERAL POVERTY GUIDELINES AT A LEVEL OF 200% OF THAT GUIDELINE. LINE 6A STURGIS HOSPITAL PUBLISHES ITS ANNUAL REPORT WHICH INCLUDES ALL RELATED ORGANIZATIONS' PROGRAMS AND SERVICES DESIGNED TO LEAD THE COMMUNITY TO IMPROVED HEALTH AND PROMOTE HEALTHY LIFESTYLES. THE REPORT IS AVAILABLE ON STURGIS'S WEBSITE. LINE 7 COLUMN F BAD DEBT EXPENSE IN THE AMOUNT OF $4,952,956 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ORGANIZATION USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS PART III LINE 4 THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENTS LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. CHARGES ARE REPORTED AT 100%, AND THE AMOUNT WRITTEN OFF TO BAD DEBT IS REDUCED TO COST BY APPLYING THE COST TO CHARGE RATIO. LINE 8 COSTING METHODOLOGY TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MCR IS A STATISTICAL STEP DOWN ALLOCATION METHOD. ANY SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL PROVIDES THESE SERVICES AS A COMMUNITY BENEFIT DESPITE THE FACT THAT THEY ARE PROVIDED AT A FINANCIAL LOSS. LINE 9B ONCE A THE EVALUATION IS COMPLETED AND A DETERMINATION HAS BEEN MADE THAT PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, NO COLLECTION EFFORTS ARE MADE. CONSIDERATION FOR ASSISTANCE IS ALSO GIVEN TO OTHER TYPES OF PATIENTS IF THE NEED FOR ASSISTANCE IS REQUIRED. PART V LINE 19D: FLAT DISCOUNT OF 100% IS PROVIDED FOR ELIGIBLE PATIENTS UNDER THE FEDERAL POVERTY GUIDELINES PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY AND AVAILABILITY OF FINANCIAL ASSISTANCE BY: POSTING THE ORGANIZATIONS CHARITY CARE POLICY IN ACCESS AND REGISTRATION AREAS WITHIN THE HOSPITAL INDIVIDUAL INTERVIEW OF PATIENTS BY FINANCIAL COUNSELORS AND PREADMISSION STAFF WITH DISCUSSIONS CONCERNING FINANCIAL ASSISTANCE, AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS AND ASSISTANCE WITH THE APPLICATION FOR ASSISTANCE. THE HOSPITAL HAS ENTERED A MEMORANDUM OF UNDERSTANDING WITH THE COUNTY WHEREAS THE HOSPITAL MAKES A COMMITMENT TO PROVIDE HEALTH CARE SERVICES TO LOW INCOME RESIDENTS OF THE COUNTY (PUBLIC RECORD) THE HOSPITAL DOES NOT INCLUDE A COPY OF THE POLICY AS PART OF THE INTAKE OR DISCHARGE PROCESS, NOR IS IT INCLUDED IN THE PATIENT BILL COMMUNITY BENEFIT REPORT THE HOSPITAL DEMONSTRATES ITS DESIRE TO FURTHER ITS EXEMPT PURPOSE AND MISSION BY: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED BY PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY (OPEN MEDICAL STAFF). ALL SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO PROMOTE SERVICE ENHANCEMENT TO ITS COMMUNITY AS WELL AS CAPITAL REPLACEMENT AND SERVICE DEVELOPMENT. THE ORGANIZATION FURTHER PROMOTES ITS MISSION BY PARTICIPATION IN HEALTH CARE SCREENING, HEALTH CARE EDUCATION AND CERTAIN SERVICES MADE TO THE COMMUNITY AT NO COST TO THE COMMUNITY. ORGANIZATION HAS ENTERED INTO MEMORANDUM OF UNDERSTANDING WITH ST.JOSEPH COUNTY COMMITTING TO PROVIDE SERVICES TO THE COMMUNITY REGARDLESS OF THE ABILITY TO PAY FOR THOSE SERVICES. COMMUNITY BENEFIT REPORT WOULD BE FILED ONLY IN THE STATE OF MICHIGAN. false false false false false false false false KEYER PATEL 525429 0 0 0 162 0 16500 0 17603 0 559694 0 0 0 ASHISH VERMA 445446 0 0 0 180 0 16500 0 20732 0 482858 0 0 0 WILSON SAWA 287155 0 0 0 180 0 16500 0 20732 0 324567 0 0 0 JAMES GRANNELL 443858 0 0 0 774 0 22000 0 17603 0 484235 0 0 0 ELIEZER MELENDEZ 438437 0 0 0 414 0 22000 0 20732 0 481583 0 0 0 DAVID SARACENO 221267 0 0 0 270 0 0 0 14238 0 235775 0 0 0 PART I LINE 3 THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS ARE LEASED FROM A MANAGEMENT COMPANY. THEREFORE, THEIR COMPENSATION IS DETERMINED AND PAID BY THIS MANAGEMENT COMPANY. CITY OF STURGIS BUILDING AUTHORITY 386004653 864108BE4 2004-12-29 10000000 HOSPITAL EXPANSION PROJECT false false false CITY OF STURGIS BUILDING AUTHORITY 386004653 864108CK9 2005-08-11 995000 HOSPITAL EXPANSION PROJECT false false false CITY OF STURGIS FACILITIES & HOSPITAL AUTHORITY 386004653 2010-04-28 2334795 HOSPITAL EXPANSION PROJECT false false false 170000 0 10044029 0 0 0 279030 0 9646199 0 0 0 2006 false false true true 20000 0 1001184 0 0 0 42584 0 958600 0 0 0 2007 false false true true 83390 0 2334795 0 0 0 43541 0 2291254 0 0 0 2012 false false false true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false 0 false 0 false false false false false 0 false 0 false false false true false 0 false 0 false false X GOVERNING BODY & MANAGEMENT PART VI, SECTION A QUESTION 1B: KAYUR PATEL, M.D. IS A PAID EMPLOYEE OF THE HOSPITAL AND IS THEREFORE CONSIDERED NON-INDEPENDENT. QUESTION 3: BOARD OF TRUSTEES HAS ENGAGED QUORUM HEALTH RESOURCES TO PROVIDE MANAGEMENT SERVICES UNDER THE STRICT POLICIES AND BY-LAWS ADOPTED BY THE BOARD OF TRUSTEES. POLICIES PART VI, SECTION B QUESTION 11: THE FORM 990 IS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM AND FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. QUESTION 12: BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. DISCLOSURES ARE REVIEWED TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT EXISTS, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT. QUESTION 15: COMPENSATION LEVELS ARE DETERMINED AT THE BOARD LEVEL UTILIZING VARIOUS SALARY SURVEYS FROM STATE HOSPITAL ASSOCIATION AS WELL AS THE MANAGEMENT COMPANY'S DATA BASE OF SALARY SCALES AND PROFESSIONAL RECRUITMENT FIRMS. QUESTION 19: STURGIS HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PART XI LINE 5 CHANGE IN DEFINED BENEFIT PENSION PLAN GAINS $386,342 UNREALIZED GAIN ON INVESTMENTS 82,000 TOTAL: $468,342