MYMICHIGAN MEDICAL CENTER GLADWIN: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MYMICHIGAN MEDICAL CENTER GLADWIN (EIN 38-6020434)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201341359349306414
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T13:28:42-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDREWS HOOPER PAVLIK PLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15300 GRATIOT RDAddressLine1
CitySAGINAWCity
StateMIState
ZIP Code486386035ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN386020434EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN MEDICAL CENTER-GLADWINBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMIDMNameControl
Phone9898393181Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1515 QUARTER STREETAddressLine1
CityGLADWINCity
StateMIState
ZIP Code48624ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANCINE M PADGETTName
TitleSR. VP & TREASURERTitle
Phone9898393181Phone
Date Signed2013-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLAURA M EBELName
Phone9894975300Phone
Date Prepared2013-05-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRAYMOND STOVERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1515 QUARTER STREETAddressLine1
CityGLADWINCity
StateMIState
ZIP Code48624ZIPCode
FieldValueIRS element (for citing)
Gross Receipts33689101GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MIDMICHIGANHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE FIRST CHOICE FOR MEDICAL CARE IN OUR COMMUNITIES AND OFFER ACCESS TO MIDMICHIGAN'S RANGE OF SPECIALTY SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees214TotalNbrEmployees
Total Nbr Volunteers103TotalNbrVolunteers
Total Gross UBI20804TotalGrossUBI
Net Unrelated Business Txbl Income-2809NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year94295ContributionsGrantsPriorYear
Contributions Grants Current Year64911ContributionsGrantsCurrentYear
Program Service Revenue Prior Year24743079ProgramServiceRevenuePriorYear
Program Service Revenue CY26031101ProgramServiceRevenueCY
Investment Income Prior Year1907626InvestmentIncomePriorYear
Investment Income Current Year1157718InvestmentIncomeCurrentYear
Other Revenue Prior Year1114219OtherRevenuePriorYear
Other Revenue Current Year1126064OtherRevenueCurrentYear
Total Revenue Prior Year27859219TotalRevenuePriorYear
Total Revenue Current Year28379794TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10068629SalariesEtcPriorYear
Salaries Etc Current Year9942926SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14626050OtherExpensePriorYear
Other Expenses Current Year17092534OtherExpensesCurrentYear
Total Expenses Prior Year24694679TotalExpensesPriorYear
Total Expenses Current Year27035460TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3164540RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1344334RevenuesLessExpensesCY
Total Assets BOY44060319TotalAssetsBOY
Total Assets EOY43936192TotalAssetsEOY
Total Liabilities BOY14612302TotalLiabilitiesBOY
Total Liabilities EOY13612695TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY29448017NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30323497NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE FIRST CHOICE FOR MEDICAL CARE IN OUR COMMUNITIES AND OFFER ACCESS TO MIDMICHIGAN'S RANGE OF SPECIALTY SERVICES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense22510504Expense
Revenue26031101Revenue
DescriptionMIDMICHIGAN MEDICAL CENTER - GLADWIN PROVIDES COMPASSIONATE PATIENT CARE SERVICES OF SUPERIOR QUALITY TO GLADWIN AND ITS SURROUNDING COUNTIES. 624 PATIENT ADMISSIONS AND 62,064 OUTPATIENT VISITS WERE RECORDED IN FISCAL YEAR 2012. CARE IS PROVIDED WITHOUT RESPECT TO PATIENT'S ABILITY TO PAY.Description
Total Program Service Expense22510504TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees214NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFM PADGETT SR VP TREASURERNamePerson
Telephone Number9898393181TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14000 WELLNESS DRIVEAddressLine1
CityMIDLANDCity
StateMIState
ZIP Code48670ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
RICHARD REYNOLDS
DIRECTOR50.00X0746845317274
RAYMOND STOVER
PRESIDENT50.00X021325763442X
CHERYL LOUBERT MD
DIRECTOR50.00X012525933937
MARY GRIFFORE
DIRECTOR30.00X0479663695
JOLENE COMPTON
DIRECTOR2.00X000
JOYCE ANN THOMPSON
DIRECTOR2.00X000
JOAN DAVID
VICE CHAIR2.00X000
RICHARD LAUER
SEC/TREAS2.00X000
GLENN SMITH
CHAIR2.00X000
CAROL CHURCHILL
DIRECTOR2.00X000
DAVID SPRANG
DIRECTOR2.00X000
JOSHUA WIGGINS
CONTROLLER50.00010985331568X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1243180TotalReportableCompFrmRltdOrgs
Total Other Compensation449916TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA303682289DIETARY SERVICE671572
MICHIGAN EMERGENCY PHYS LLP
PO BOX 793TRAVERSE CITYMI496850793ER ADMIN577975
THREE RIVERS CONSTRUCTION INC
PO BOX 1467MIDLANDMI48641CONSTRUCTION116676
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
All Other Contributions64911AllOtherContributions
Total Contributions64911TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MEDICARE/MEDICAID PAYMENTS6219901651944316519443
PATIENT REVENUE62199093687529368752
CONTRACTED CLINICAL SERVICES621990122102122102
REFERENCE LABORATORY6215002080420804
FieldValueIRS element (for citing)
Total Program Service Revenue26031101TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column500259TotalRevenueColumn
Exclusion$500,259ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5966766Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5302299Securities
Other7008Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities664467Securities
Other-7008Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column657459TotalRevenueColumn
Exclusion$657,459ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
AFFILIATE RELATED INCOME900099954164954164
CAFETERIA/FOOD SERVICE722210121944$121,944
OUTSIDE INCOME9000991705717057

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column32899TotalRevenueColumn
Exclusion$32,899ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1126064TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column28379794TotalRevenueColumn
Related Or Exempt Function Income26981518RelatedOrExemptFunctionIncome
Unrelated Business Revenue20804UnrelatedBusinessRevenue
Exclusion$1,312,561ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7783843Total
Program Services7226277ProgramServices
Management And General557566ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total301552Total
Program Services283275ProgramServices
Management And General18277ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1296433Total
Program Services1062757ProgramServices
Management And General233676ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total561098Total
Program Services521718ProgramServices
Management And General39380ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1260Total
Management And General1260ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total14889Total
Management And General14889ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total62697Total
Management And General62697ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4447259Total
Program Services2870621ProgramServices
Management And General1576638ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total34685Total
Program Services3852ProgramServices
Management And General30833ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total935171Total
Program Services732940ProgramServices
Management And General202231ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total705774Total
Management And General705774ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total8822Total
Program Services8765ProgramServices
Management And General57ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1113293Total
Program Services1103845ProgramServices
Management And General9448ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total24052Total
Program Services20103ProgramServices
Management And General3949ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13430Total
Program Services10352ProgramServices
Management And General3078ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total573050Total
Management And General573050ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1133953Total
Program Services662491ProgramServices
Management And General471462ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total21380Total
Program Services689ProgramServices
Management And General20691ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES26335972633597
PHYSICIAN PRACTICE SUBSID25718292571829
UNCOMPENSATED SERVICES22983432298343
QAAP FEES499050499050

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total27035460Total
Program Services22510504ProgramServices
Management And General4524956ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY920BOY
EOY745EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY671764BOY
EOY1200328EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3327756BOY
EOY4188738EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY8466BOY
EOY4605EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY355412BOY
EOY365013EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18720811LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec12067237LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6736652BOY
EOY6653574EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4861600BOY
EOY3753459EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY27904404BOY
EOY27585419EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY193345BOY
EOY184311EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY44060319BOY
EOY43936192EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1906700BOY
EOY1853668EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY10684074BOY
EOY10426649EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2021528BOY
EOY1332378EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14612302BOY
EOY13612695EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY29377982BOY
EOY30207590EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY70035BOY
EOY115907EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29448017BOY
EOY30323497EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY44060319BOY
EOY43936192EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1344334ReconcilationRevenueExpenses
Reconcilation Other Changes-468854ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis22860OtherCostOrOtherBasis
Book Value22860BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10143614OtherCostOrOtherBasis
Depreciation5997786Depreciation
Book Value4145828BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis294761OtherCostOrOtherBasis
Depreciation258523Depreciation
Book Value36238BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7891219OtherCostOrOtherBasis
Depreciation5810928Depreciation
Book Value2080291BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis368357OtherCostOrOtherBasis
Book Value368357BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6653574TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionOTHER FINANCIAL INVESTMENTSDescription
Book Value27585419BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities27585419TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
SELF-INSURANCE, DEFERRED COMP, OTHER$1,035,869
INTERCOMPANY NOTES PAYABLE$296,509
FieldValueIRS element (for citing)
Total Of Amounts1332378TotalOfAmounts
Total Revenue28379794TotalRevenue
Total Expenses27035460TotalExpenses
Excess Or Deficit For Year1344334ExcessOrDeficitForYear
Net Unrealized GL On Investments-379275NetUnrealizedGLOnInvestments
Other-$89,579OtherAmount
Total Adjustments-468854TotalAdjustments
Excess Or Deficit Per FS875480ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt27953280TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-379275NetUnrealizedGainsInvestments
Other Revenues8450OtherRevenues
Revenue Not Rptd F990-370825RevenueNotRptdF990
Revenue Subtotal28324105RevenueSubtotal
Investment Expenses Not Included62697InvestmentExpensesNotIncluded
Other Revenues Not Included-7008OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt55689RevenueNotRptdOnFinStmt
Total Revenue Per Form99028379794TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt26998221TotExpensesEtcAuditedFinclStmt
Other Expenses Included18450OtherExpensesIncluded
Expenses Not Rptd F99018450ExpensesNotRptdF990
Expenses Subtotal26979771ExpensesSubtotal
Investment Expenses Not Included262697InvestmentExpensesNotIncluded2
Other Expenses Not Included-7008OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt55689ExpensesNotRptdOnFinStmt
Total Expenses Per Form99027035460TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8NET ASSETS RELEASED FROM RESTRICTIONS 8,450 LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED 7,008 NET ASSETS RELEASED FROM RESTRICTIONS -18,450 LOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -7,008
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DNET ASSETS RELEASED FROM RESTRICTIONS 8,450
REVENUE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BLOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -7,008
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DNET ASSETS RELEASED FROM RESTRICTIONS 18,450
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 4BLOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -7,008

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense150854TotalCommunityBenefitExpense
Net Community Benefit Expense150854NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense4075590TotalCommunityBenefitExpense
Direct Offsetting Revenue2319709DirectOffsettingRevenue
Net Community Benefit Expense1755881NetCommunityBenefitExpense
Percent Of Total Expense0.06490PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Benefit Expense4226444TotalCommunityBenefitExpense
Direct Offsetting Revenue2319709DirectOffsettingRevenue
Net Community Benefit Expense1906735NetCommunityBenefitExpense
Percent Of Total Expense0.07050PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs102NumberOfActivitiesOrPrograms
Persons Served5184PersonsServed
Total Community Benefit Expense200023TotalCommunityBenefitExpense
Direct Offsetting Revenue12375DirectOffsettingRevenue
Net Community Benefit Expense187648NetCommunityBenefitExpense
Percent Of Total Expense0.00690PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs18NumberOfActivitiesOrPrograms
Persons Served17PersonsServed
Total Community Benefit Expense36927TotalCommunityBenefitExpense
Net Community Benefit Expense36927NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs129NumberOfActivitiesOrPrograms
Persons Served6368PersonsServed
Total Community Benefit Expense25482TotalCommunityBenefitExpense
Direct Offsetting Revenue2016DirectOffsettingRevenue
Net Community Benefit Expense23466NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs249NumberOfActivitiesOrPrograms
Persons Served11569PersonsServed
Total Community Benefit Expense262432TotalCommunityBenefitExpense
Direct Offsetting Revenue14391DirectOffsettingRevenue
Net Community Benefit Expense248041NetCommunityBenefitExpense
Percent Of Total Expense0.00920PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs251NumberOfActivitiesOrPrograms
Persons Served11569PersonsServed
Total Community Benefit Expense4488876TotalCommunityBenefitExpense
Direct Offsetting Revenue2334100DirectOffsettingRevenue
Net Community Benefit Expense2154776NetCommunityBenefitExpense
Percent Of Total Expense0.07970PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs39NumberOfActivitiesOrPrograms
Persons Served780PersonsServed
Total Community Building Expense5372TotalCommunityBuildingExpense
Net Community Building Expense5372NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs39NumberOfActivitiesOrPrograms
Persons Served342PersonsServed
Total Community Building Expense2753TotalCommunityBuildingExpense
Net Community Building Expense2753NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Total Community Building Expense870TotalCommunityBuildingExpense
Net Community Building Expense870NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served122PersonsServed
Total Community Building Expense1061TotalCommunityBuildingExpense
Net Community Building Expense1061NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served140PersonsServed
Total Community Building Expense370TotalCommunityBuildingExpense
Net Community Building Expense370NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense16420TotalCommunityBuildingExpense
Net Community Building Expense16420NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs102NumberOfActivitiesOrPrograms
Persons Served1384PersonsServed
Total Community Building Expense26846TotalCommunityBuildingExpense
Net Community Building Expense26846NetCommunityBuildingExpense
Percent Of Total Expense0.00100PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$996,373BadDebtExpenseAmount
Amount Attributable To133023AmountAttributableTo
Amount Reimbursed By Medicare9876526AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9886173CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-9647MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN MEDICAL CENTER-GLADWINBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1515 QUARTER STREETAddressLine1
CityGLADWINCity
StateMIState
ZIP Code48624ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN MEDICAL CENTER-GLADWINBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent150.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Other FactorsXOtherFactors
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
GLADWIN MEDICAL OFFICES - GLADWIN
609 QUARTER STREETGLADWINMI48624RURAL HEALTH CLINIC
GLADWIN MEDICAL OFFICES - BEAVERTON
439 S M-18BEAVERTONMI48612PHYSICIAN OFFICE, LAB, RADIOLOGY
MIDMICHIGAN HEALTH PARK-WEST BRANCH
640 COURT STREETWEST BRANCHMI48661PHYSICIAN OFFICE, LAB, RADIOLOGY

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMMUNITY BUILDING ACTIVITIESPART IIMIDMICHIGAN MEDICAL CENTERGLADWIN EMPLOYEES CONTRIBUTED MANY HOURS AS MEMBERS OF COMMUNITY BOARDS CIVIC ORGANIZATIONS ADVISORY COMMITTEES COALITIONS AND WORK GROUPS GLADWIN EMPLOYEES SERVE ADVISORY AND OTHER KEY ROLES FOR NONPROFIT BOARDS ANDOR COMMITTEES PROVIDING OVERSIGHT OF COMMUNITY GRANT REQUESTS FOR HEALTH AND HUMAN SERVICES PROJECTS AND PARTICIPATING IN STRATEGIC INITIATIVES THROUGH THE TOGETHER WE CAN ADVISORY COMMITTEE WHICH INVOLVES CLARE ISABELLA AND GLADWIN COUNTY MIDMICHIGAN MEDICAL CENTERGLADWIN ADMINISTRATORS SIT ON VARIOUS COMMUNITY BOARDS OF DIRECTORS SUCH AS THE AMERICAN RED CROSS MIDMICHIGAN MEDICAL CENTERGLADWIN ALSO SPENT APPROXIMATELY 7800 IN PHYSICIAN RECRUITMENT FOR THE FISCAL YEAR OF 2012
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4OTHER UNCOMPENSATED CARE REPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH PAYMENT IS EXPECTED AT THE TIME SERVICE IS PROVIDED BUT PAYMENT IS NOT RECEIVED OR IS LESS THAN THE COST INCURRED TO PROVIDE THE SERVICE THE FOLLOWING IS INCLUDED AS PROGRAMS AND SERVICES RELATED TO OTHER UNCOMPENSATED CARE UNCOMPENSATED SERVICES AT COSTREPRESENTS THE COST OF SERVICES PROVIDED FOR WHICH A FEE HAS BEEN ASSESSED BUT NOT COLLECTED OR ONLY A PORTION OF THE COST OF THE RENDERED SERVICE HAS BEEN RECOVERED LINE 2 COSTING METHODOLOGY AN AVERAGE COSTTOCHARGE RATIO IS APPLIED TO THE CHARGE WRITEOFF THE RATIO IS CALCULATED BY REMOVING FROM TOTAL EXPENSE THE OTHER OPERATING INCOME UNCOMPENSATED CARE EXPENSE AND THE DIRECTLY ASSIGNED MEDICAID ASSESSMENT EXPENSE THEN DIVIDING THIS NET EXPENSE BY TOTAL GROSS PATIENT REVENUES THIS RATIO IS MULTIPLIED WITH THE CHARITY CARE CHARGES AND UNCOMPENSATED CARE CHARGES WRITTEN OFF FOR THE RELATED EXPENSE LINE 3 HISTORICAL COLLECTION ACTIVITY OBTAINED FROM 3RD PARTY COLLECTION AGENCIES IS USED TO ESTIMATE THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE
MEDICARE EXPLANATIONPART III LINE 8THE SOCIAL SECURITY ACT AMENDMENT TO ESTABLISH MEDICARE STATES THAT MEDICARE WILL NOT PAY THE COST TO PROVIDE CARE TO NONBENEFICIARIES AND NONBENEFICIARIES WILL NOT PAY THE COST OF CARE FOR BENEFICIARIES WHEN MEDICARE DOES NOT PAY RATES THAT COVER ALL THE COST OF CARE FOR BENEFICARIES IT BECOMES A COMMUNITY BURDEN THEREFORE THE FULL AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT THIS ORGANIZATION BELIEVES THE AUDITED FINANCIAL STATEMENT CALCULATION IS A MORE ACCURATE DETERMINATION OF COST THAN THE MEDICARE ALLOWABLE COSTS USED FOR COST REPORTS THAT ARE REQUIRED TO BE UTILIZED ON THIS SCHEDULE IN PART III SECTION B THE AUDITED FINANCIAL STATEMENTS INCLUDE ALL MEDICARE REVENUES AND COSTS AND ALSO USE A COSTTOCHARGE RATIO METHOD THE AUDIT CALCULATION REPORTS A MEDICARE SHORTFALL OF 647463 FOR THIS ORGANIZATION FOR THE FISCAL YEAR ENDED JUNE 30 2012
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BMIDMICHIGAN HEALTH DOES NOT TRY TO COLLECT FROM THOSE WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE MIDMICHIGAN HEALTHS COLLECTION POLICY STATES THAT THE PURPOSE OF THE POLICY IS TO PROVIDE COST EFFECTIVE PAYMENT OPTIONS TO PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE PER FINANCIAL AIDCHARITY CARE POLICY AND EITHER HAVE NO INSURANCE OR HAVE A BALANCE AFTER INSURANCE WHICH IS THEIR RESPONSIBILITY TO PAY
NEEDS ASSESSMENTPART VIMIDMICHIGAN MEDICAL CENTER GLADWIN HAS PROVIDED COMMUNITY BENEFITS TO THE AREAS WE SERVE THROUGH DIRECT FINANCIAL ASSISTANCE TO PATIENTS SUBSIDIZED PROGRAMS AND COMMUNITY OUTREACH PROGRAMS INCLUDING HEALTH CARE SCREENINGS AND OTHER PREVENTION PROGRAMS DATA FROM A VARIETY OF LOCAL AND NATIONAL SOURCES IS UTILIZED TO DETERMINE CURRENT HEALTH CARE TRENDS AND HEALTH CARE ISSUES AND TO PRIORITIZE AND EVALUATE HEALTH CARE PROGRAM PROGRESS SOURCES FOR GENERAL HEALTH DATA FOLLOW CDC MICHIGAN BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM BRFSS 20062008 COMBINED ADULT AND YOUTH COUNTY HEALTH RANKINGS UNIVERSITY OF WISCONSIN DATA CDC DATA AND STATISTICS USED FOR GENERAL AND AGE SPECIFIC AND HEALTH CONDITION DATA SUCH AS AGING TOBACCO USE VACIINES AND IMMUNIZATIONS MICHIGAN DEPARTMENT OF COMMUNITY HEALTH MDCH VITAL STATISTICS DHHS COMMUNITY HEALTH STATUS INDICATORS DHHS MEDICARE COMPARE DHHS MATERNAL AND CHILD HEALTH RESOURCE CENTER US DEPARTMENT OF HEALTH AND HUMAN SERVICES STATISTICS LINKS ADDITIONALLY WE USE DISEASE SPECIFIC DATA FROM NATIONAL ORGANIZATIONS LIKE THE AMERICAN CANCER SOCIETY THE AMERICAN DIABETES ASSOCIATION WHO COUNTRY AND REGIONAL DIABETES DATA AMERICAN HEART ASSOCIATION HEART AND OBESITY PREVENTION INFORMATION NATIONAL CANCER INSTITUTE CANCER STUDIES AND CDC FUNDED STATISTICS ON HIVAIDS LUNG CANCER SEXUALLY TRANSMITTED DISEASES NATIONAL CENTER FOR HEALTH STATISTICSMENTAL DISORDERS FOR HEALTH CARE COVERAGE AND FINANCE WE REFER TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES RESEARCH STATISTICS AND DATA SYSTEMS NATIONAL CENTER FOR HEALTH STATISTICS THE US CENSUS BUREAU AND THE KAISER FAMILY FOUNDATION
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIWE COMMUNICATE TO PATIENTS AND THE PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE THROUGH INFORMATIONAL BROCHURES AT REGISTRATION AREAS AND THROUGH PATIENT ACCOUNTING COUNSELORS PATIENT ACCOUNTING COUNSELORS ARE TRAINED TO HELP PATIENTS OBTAIN FREE OR LOWCOST HEALTH INSURANCE OR TO WORK WITH PATIENTS TO PROVIDE CHARITY CARE OR FINANCIAL AID BASED ON THEIR FINANCIAL STATUS ADDITIONALLY SOCIAL WORKERS PROVIDE INFORMATION BOTH WRITTEN AND VERBAL ABOUT PROGRAMS FOR ASSISTANCE THEY ALSO COORDINATE WITH THE MEDICAID ELIGIBILITY REPRESENTATIVE FROM DHS FOR FOLLOWUP OR EXPEDITED APPLICATIONS THEY PROVIDE MEDICAID APPLICATIONS PERSONAL FINANCIAL STATEMENTS FOR HOSPITAL CHARITY CARE AND REFER TO THE PATIENT ACCOUNTING COUNSELORS
COMMUNITY INFORMATIONPART VIMIDMICHIGAN MEDICAL CENTERGLADWINS PRIMARY SERVICE AREA IS COMPRISED OF THE 2 ZIP CODES WHICH CAPTURE GLADWIN COUNTY 856 OF THEIR DISCHARGES ORIGINATED IN THESE ZIP CODES AND THEIR INPATIENT MARKET SHARE IS 150 MIDMICHIGAN MEDICAL CENTERMIDLAND ALSO SERVES THIS COMMUNITY RECEIVING A 482 MARKET SHARE FOLLOWED BY MCLARENBAY REGION WITH 56 OF THE INPATIENT MARKET AND COVENANT CAPTURING 54 OF THIS MARKET GLADWIN COUNTY IS A DESIGNATED MEDICALLY UNDERSERVED POPULATION AS WELL AS A DESIGNATED SINGLE COUNTY HEALTHCARE PROVIDER SHORTAGE AREA DEMOGRAPHICS 2012 OVER AVERAGE MEDIAN NUMBER OF MEDIAN POPULATION 65 YEARS INCOME INCOME HOUSEHOLDS AGE 24941 215 45378 35251 10392 466 RACE PERCENT WHITE PERCENT PERCENT PERCENT PERCENT CAUCASIAN ASIAN INDIAN HISPANIC BLACK 978 03 04 13 02
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIOUR FOCUS ON IMPROVING THE HEALTH OF OUR COMMUNITIES IS REFLECTED IN OUR MISSION VALUES AND VISION WE PARTNER WITH SCHOOLS BUSINESSES AND HEALTH CARE AGENCIES TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITIES SERVED ACTIVE COMMUNITY MEMBER BOARDS OVERSEE OUR COMMUNITY OUTREACH ENDEAVORS WE PARTNER ON NEEDED HEALTH INITIATIVES WORKING WITH LOCAL PUBLIC HEALTH DEPARTMENTS AND HEALTH AND HUMAN SERVICE AGENCIES TO UNDERSTAND THE UNIQUE HEALTH NEEDS OF EACH OF OUR COMMUNITIES WE COLLABORATE WITH LOCAL AGENCIES TO HELP DETERMINE AND RESPOND TO LOCAL NEEDS FOR EXAMPLE THE MIDMICHIGAN COMMUNITY ACTION AGENCY COMMUNITY NEEDS ASSESSMENT IS COMPLETED EVERY THREE YEARS AND INCLUDES CLARE GLADWIN AND MIDLAND COUNTIES THIS SURVEY ADDRESSES HEALTH CARE COST INCLUDING PRESCRIPTION MEDICATIONS AFFORDABLE PREVENTATIVE HEALTH CARE AND TRANSPORTATION TO SERVICES WE ALSO SIT ON A COLLABORATIVE PARTNERSHIP HEADED BY THE HEALTH DEPARTMENT CALLED TOGETHER WE CAN AND A SMALLER SUBSET OF THAT GROUP THE CLARE GLADWIN HEALTH IMPROVEMENT PLAN WHICH ADDRESSES WAYS COMMUNITY ORGANIZATIONS CAN IMPLEMENT PROGRAMS TO BETTER OVERALL COUNTY HEALTH AND THEIR RANKINGS AS DETERMINED BY THE ROBERT WOOD JOHNSON FOUNDATION COUNTY HEALTH RANKINGS
AFFILIATED HEALTH CARE INFORMATIONPART VI59 MILLION IN COMMUNITY BENEFITS WAS PROVIDED BY MIDMICHIGAN HEALTH LAST YEAR THROUGH COMMUNITY EDUCATION PROGRAMS SCREENINGS SPECIAL EVENTS AND HEALTH EXPERTISE INCLUDING INSURANCE UNDERREIMBURSEMENTS AND SERVICES TO THOSE WHO COULD NOT PAY AREAS OF FOCUS IN THE MIDMICHIGAN HEALTH COMMUNITY BENEFIT PLANS ARE ACCESS TO CARE INCLUDING INITIATION AND COORDINATION OF CARE CONTINUITY OF SERVICES AND HEALTH CARE INSURANCE HEALTH OUTCOMES INCLUDING HEART DISEASE CANCER AND DIABETES HEALTH CARE BEHAVIORS INCLUDING SMOKING CESSATION HEALTHY DIET PHYSICAL ACTIVITY AND HEALTHY WEIGHT MATERNAL AND INFANT HEALTH INCLUDING BIRTH WEIGHTS AND BREASTFEEDING WOMENS HEALTH CONFERENCES IN GLADWIN ALMA AND MIDLAND CHALLENGED ATTENDEES TO TAKE CHARGE OF THEIR HEALTH SET GOALS AND ESTABLISH ACTIONS FOR POSITIVE CHANGE THE MARCH CONFERENCES FEATURED ADVICE FROM MIDMICHIGAN HEALTH PROVIDERS AND THE WOMENS GUIDE TO LIVING WELL PARTICIPANTS RECEIVED FOLLOWUP CALLS A FEW MONTHS LATER TO SEE IF CHANGED BEHAVIORS HAD BECOME HEALTHY HABITS IN AN EFFORT TO IMPROVE BREASTFEEDING DURATION RATES ADDITIONAL BREASTFEEDING SUPPORT VIA BREASTFEEDING FACILITATORS AND SCHOLARSHIPS FOR THOSE WHO COULD NOT AFFORD BREASTFEEDING PREPARATION CLASS WERE PROVIDED HEALTH SCREENINGS PROVIDED A CONVENIENT FREE OR LOWCOST MEANS FOR DETECTING POTENTIALLY SERIOUS HEALTH PROBLEMS IN THEIR EARLIEST STAGES WHEN TREATMENT IS USUALLY MORE SUCCESSFUL RESULTING IN LOWER MORBIDITY OR MORTALITY EVENTS INCLUDED SCREENINGS FOR SKIN AND ORAL CANCER STROKE AND OSTEOPOROSIS AND KNOW YOUR NUMBERS TOTAL LIPID PROFILE BLOOD GLUCOSE BLOOD PRESSURE WEIGHT BODY MASS INDEX AND WAIST CIRCUMFERENCE MIDMICHIGAN SCREENED 13374 PEOPLE AT 428 EVENTS IN OUR SERVICE AREA THIS YEAR AT A COST OF 184588 IN AN EFFORT TO ADDRESS INCREASING OBESITY AND CHOLESTEROL LEVELS AND DECREASING PHYSICAL ACTIVITY AMONG CHILDREN MIDMICHIGAN HEALTH AND THE GREAT LAKES LOONS CREATED LOU ES FIT CLUB AND THE FITNESS WATCH PROJECT THE GOAL IS TO INCREASE KIDS MODERATEINTENSITY ACTIVITY FOR BETTER PHYSICAL FITNESS AND LESS CHILDHOOD OBESITY CHILDREN 6 TO 12 JOIN FREE TO ENJOY EVENTS AND RECEIVE A MONTHLY EMAIL NEWSLETTER ABOUT BEING HEALTHY AND ACTIVE AT THE DOW DIAMOND FITNESS POSTERS AT LOU ES LOOKOUT DEMONSTRATE EIGHT EXERCISES THAT KIDS CAN DO ANYWHERE FOR EVERY 60 MINUTES OF MODERATEINTENSITY ACTIVITY THE FITNESS WATCH PROVIDES A REWARD CODE STUDENTS CAN EXCHANGE FOR FUN PRIZES SIXHUNDRED STUDENTS FROM FOUR MIDLAND ELEMENTARY SCHOOLS USED LOU ES ACTIVITY WATCH FOR SIX MONTHS AND AT LEAST 50 PERCENT IMPROVED THEIR FITNESS LEVELS ADDITIONALLY HEALTH FAIRS REACHED OUT TO ENCOURAGE AND TEACH CHILDREN ABOUT REGULAR EXERCISE GOOD NUTRITION AND MAINTAINING A HEALTHY WEIGHT MIDMICHIGAN HEALTH COLLABORATED WITH SCHOOLS ON SOME OF THESE PROGRAMS MIDMICHIGAN MEDICAL CENTERGLADWIN LAUNCHED THE GLADWIN COUNTY ADOLESCENT HEALTH COUNCIL TO IMPROVE ADOLESCENT HEALTH BY PARTNERING WITH COMMUNITY STAKEHOLDERS ADOLESCENTS ARE MORE SUCCESSFUL IN MAKING HEALTHY CHOICES WHEN FAMILIES PARTICIPATE SO THIS YEARS PROGRAM EXPANDED THE HOSPITALS YOUTH HEALTH FAIRS TO INCLUDE FAMILY FITNESS FOLLOWUP NIGHTS FEATURING HEALTHY LIVING AND NUTRITION EDUCATION GOALSETTING AND PHYSICAL TRAINING CHALLENGES WITH PRIZES HEALTH PROFESSIONALS ALSO MET WITH PARENTS WHO HAD QUESTIONS ABOUT THEIR STUDENTS HEALTH FAIR SCREENING RESULTS
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VIMICHIGAN
ADDITIONAL INFORMATIONPART VIPART I LINES 3A AND 3B AS WELL AS USING THE FEDERAL POVERTY GUIDELINES THE PATIENTS AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT ARE TAKEN INTO CONSIDERATION WHEN DETERMINING FREE OR DISCOUNTED CARE PATIENTS WHOSE FAMILY INCOME EXCEEDS 200 OF THE FPG MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASEBYCASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE
MIDMICHIGAN MEDICAL CENTERGLADWIN LINE NUMBER 1 PART V LINE 11HPART V LINE 11HPATIENT RELIGIOUS BELIEF PREVENT HIMHER FROM PARTICIPATING DIRECTLY WITH AN INSURANCE COMPANY
MIDMICHIGAN MEDICAL CENTERGLADWIN LINE NUMBER 1 PART V LINE 13GPART V LINE 13GTHE COMPLETE POLICY IS NOT PUBLISHED HOWEVER NOTICES OF THE EXISTENCE OF A FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN REGISTRATION AREAS INCLUDING EMERGENCY ROOM PATIENT BILLING INVOICES AND THE HOSPITAL WEBSITE INDICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE
MIDMICHIGAN MEDICAL CENTERGLADWIN LINE NUMBER 1 PART V LINE 21PART V LINE 21PATIENTS WHO DID NOT FOLLOW THEIR INSURANCE POLICY RULES SUCH AS ACCESSING PARTICIPATING PROVIDERS OBTAINING REFERRALS ETC GUARANTORS REFUSING TO ASSIGN BENEFITS TO THE HOSPITAL IF THEY ARE AVAILABLE PATIENTS WHO ARE UNCOOPERATIVE WITH THE MEDICAID APPLICATION PROCESS

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
RICHARD REYNOLDS
52673020000020115293201240731064119
RAYMOND STOVER
15390346500128544510918333276699
CHERYL LOUBERT MD
107970168814081322220715159196

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NON-FIXED PAYMENTS PROVIDEDSCHEDULE J, PAGE 1, PART I, LINE 7MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, ALL OPERATING OFFICERS AND COMPENSATION FOR THE AFFILIATE CEOS, OPERATING OFFICERS AND PHYSICIANS. THE AFFILIATE BOARDS OF DIRECTORS REVIEWED ALL FIXED AND NONFIXED PAYMENTS FOR THEIR CEO AND OPERATING OFFICERS PRIOR TO PAYMENT.
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIION MAY 8, 2009 MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE APPROVED ITS FIRST COMPENSATION COMMITTEE CHARTER AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH APPROVED BOTH THE CHARTER AND THE STRATEGY ON JUNE 8, 2009. MIDMICHIGAN HEALTH ALSO UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE, PRIMARILY IN THE MIDWEST AND REGIONALLY, BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. PART I, LINE 4B - REYNOLDS IS A PARTICIPANT IN A 457(F) PLAN. THERE WERE NO PAYMENTS MADE IN 2011. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANTS ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403(B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, PROVIDED THEY HAVE BEEN EMPLOYED AT LEAST FIVE YEARS AND THE PARTICIPANT EARNS 75 POINTS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MICHIGAN STATE HOSPITAL FINANCE
38288941759465HEB82006-11-074332800CAPITAL PROJECTSfalsefalsefalse
MICHIGAN STATE HOSPITAL FINANCE
38288941759465HLF12009-06-173000000CAPITAL PROJECTSfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
43328002502043948242009falsefalsetruetrue
30000004444029347522011falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalsefalse0.003300.00330true
falsefalsefalsefalsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE KReturnReference
ExplanationMICHIGAN STATE HOSPITAL FINANCE IT HAS BEEN DETERMINED THAT NO ARBITRAGE REBATE IS DUE FOR THESE BOND ISSUES COLUMNS A AND B THEREFORE FORM 8038T IS NOT REQUIREDExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. OUR VISION IS: AS PART OF A PREMIER INTEGRATED HEALTH SYSTEM, COMMITTED TO SUPERIOR QUALITY, INNOVATION AND VALUE, WE ARE THE FIRST CHOICE FOR MEDICAL CARE IN OUR COMMUNITIES AND OFFER ACCESS TO MIDMICHIGAN'S RANGE OF SPECIALTY SERVICES.
ADDITIONAL INFORMATIONFORM 990ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION. PART I, LINES 3 & 4 AND PART VI, SECTION A, LINE 1 - THOSE MEMBERS WHO ARE NOT INDEPENDENT ARE EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION LISTED IN SCHEDULE R AND ARE COMPENSATED AT MARKET VALUE FOR THE SERVICES PROVIDED TO THAT ORGANIZATION.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATHE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BTHE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF ANY AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 INFORMATION IS PREPARED BY THE FINANCE STAFF AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS ORGANIZATION. THE INFORMATION IS SUBMITTED FOR REVIEW BY A SENIOR FINANCE STAFF MEMBER AT MIDMICHIGAN HEALTH. THE STAFF MEMBER IN CONSULTATION WITH OUR TAX ACCOUNTANT (A CERTIFIED PUBLIC ACCOUNTING FIRM) REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. ONCE THE INITIAL REVIEW IS COMPLETE, THE INFORMATION IS SUBMITTED TO OUR TAX PROFESSIONALS AT ANDREWS HOOPER PAVLIK PLC. UPON REVIEW BY THEIR PROFESSIONALS, INCLUDING A PARTNER, INFORMATION IS RETURNED TO MIDMICHIGAN HEALTH FOR ITS FINAL REVIEW. THIS REVIEW INCLUDES A REVIEW BY THE SVP AND TREASURER. ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION WILL BE REVIEWED BY THE COMPENSATION COMMITTEE. FORM 990, INCLUDING ALL SCHEDULES, WILL BE MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN PRIOR TO FILING. QUESTIONS OR CONCERNS WILL BE ADDRESSED BY THE SVP AND TREASURER. THE RESULTS OF THESE REVIEWS WILL BE PRESENTED TO THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUES IN WHICH THEY ARE NOT IMPARTIAL.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH AND THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BALL OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIINO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES IS NOT TRACKED BY AFFILIATE. THEREFORE THE FULL TIME SERVICE TO ALL AFFILIATES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5CHANGES IN NET ASSETS: UNREALIZED LOSS ON INVESTMENTS (379,275) TRANSFER OF NET ASSETS TO A RELATED TAX EXEMPT ENTITY (89,579) ---------- TOTAL CHANGES IN NET ASSETS (468,854)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MIDMICHIGAN HEALTH
4000 WELLNESS DRIVEMIDLANDMI48670382459948SUPPORTMI501C311ANAfalse
MIDMICHIGAN MEDICAL CENTER-MIDLAND
4000 WELLNESS DRIVEMIDLANDMI48670380833014HOSPITALMI501C33MIDMI HLTHtrue
MIDMICHIGAN MEDICAL CENTER-GRATIOT
300 E WARWICK DRALMAMI48801381437919HOSPITALMI501C33MIDMI HLTHtrue
MIDMICHIGAN MEDICAL CENTER-CLARE
703 NORTH MCEWAN STREETCLAREMI48617381518643HOSPITALMI501C33MIDMI HLTHtrue
MIDMICHIGAN STRATFORD VILLAGE
2121 ROCKWELL DRMIDLANDMI48642382623324LT CAREMI501C39MIDMI HLTHtrue
MIDMICHIGAN GLADWIN PINES
449 QUARTER STREETGLADWINMI48624382754875LT CAREMI501C39MIDMI HLTHtrue
MIDMI VNA DBA MIDMICHIGAN HOME CARE
3007 N SAGINAW RDMIDLANDMI48640381459397CARE/EQUIPMI501C39MIDMI HLTHtrue
MIDMICHIGAN PHYSICIANS GROUP
2620 W SUGNET ROADMIDLANDMI48640383317788MED OFFICEMI501C311AMIDMI HLTHtrue
MIDMICHIGAN REGIONAL IMAGING
4000 WELLNESS DRIVEMIDLANDMI48670352182295EQUIPMENTMI501C311BMIDMI HLTHtrue
MIDMICHIGAN URGENT CARE
3009 N SAGINAW RDMIDLANDMI48640205064848AMBULATORYMI501C39MIDMI HLTHtrue
MIDMICHIGAN HEALTH DEV ASSOC
4000 WELLNESS DRIVEMIDLANDMI48670382459947OPERATIONSMI501C2MIDMI HLTHtrue
REGIONAL DIALYSIS SERVICES
PO BOX 188ALMAMI48801383120704DIALYSISMI501C311AMIDMI HLTHtrue
MIDMI MEDICAL CENTER-GLADWIN AUX
515 QUARTER STREETGLADWINMI48624382316532SUPPORTMI501C311ANAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN ASSURANCE GROUP LTDBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line1PO BOX 1051 23 LIME TREE BAY AVENUEAddressLine1
Address Line2GOVERNORS SQUARE BLDG 4 2ND FLOORAddressLine2
Province Or StateGRAND CAYMANProvinceOrState
CountryCJCountry
FieldValueIRS element (for citing)
EIN980585596EIN
Primary ActivityINSURANCEPrimaryActivity
Legal Domicile Foreign CountryCJLegalDomicileForeignCountry

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MIDMI HLTHBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (18 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MIDMICHIGAN REGIONAL IMAGING
J689216BOOKS RECORDS
MIDMICHIGAN HEALTH DEV ASSOC
J71064BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-MIDLAND
O2026552BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-GRATIOT
O62240BOOKS RECORDS
MIDMICHIGAN HEALTH
O758816BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
O2388364BOOKS RECORDS
MIDMICHIGAN GLADWIN PINES
P784447BOOKS RECORDS
MIDMICHIGAN HEALTH DEV ASSOC
P59473BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
Q89579BOOKS RECORDS
MIDMICHIGAN REGIONAL IMAGING
J689216BOOKS RECORDS
MIDMICHIGAN HEALTH DEV ASSOC
J71064BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-MIDLAND
O2026552BOOKS RECORDS
MIDMICHIGAN MEDICAL CENTER-GRATIOT
O62240BOOKS RECORDS
MIDMICHIGAN HEALTH
O758816BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
O2388364BOOKS RECORDS
MIDMICHIGAN GLADWIN PINES
P784447BOOKS RECORDS
MIDMICHIGAN HEALTH DEV ASSOC
P59473BOOKS RECORDS
MIDMICHIGAN PHYSICIANS GROUP
Q89579BOOKS RECORDS

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