HENRY FORD HEALTH ROCHESTER HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HENRY FORD HEALTH ROCHESTER HOSPITAL (EIN 38-1359247)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201343199349304799
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T11:39:30-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1 |
| City | SOUTHFIELD | City |
| State | MI | State |
| ZIP Code | 480370307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381359247 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENTON HOSPITAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CRIT | NameControl |
| Phone | 2486525000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY DRIVE | AddressLine1 |
| City | ROCHESTER | City |
| State | MI | State |
| ZIP Code | 48307 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROY POWELL | Name |
| Title | CEO | Title |
| Phone | 2486525000 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN MIENCIER | Name |
| PTIN | P00842339 | PTIN |
| Phone | 2483522500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROY POWELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY DRIVE | AddressLine1 |
| City | ROCHESTER | City |
| State | MI | State |
| ZIP Code | 48307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 430295292 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CRITTENTON.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1900 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO ENHANCING THE HEALTH STATUS OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1918 | TotalNbrEmployees |
| Total Nbr Volunteers | 404 | TotalNbrVolunteers |
| Total Gross UBI | 4659267 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -622910 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 9165492 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 11198382 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 225567987 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 233276423 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6129991 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5562766 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1064217 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1732366 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 241927687 | TotalRevenuePriorYear |
| Total Revenue Current Year | 251769937 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 139050 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 80517 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 103353571 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 107042722 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 3147 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 135377209 | OtherExpensePriorYear |
| Other Expenses Current Year | 142225558 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 238869830 | TotalExpensesPriorYear |
| Total Expenses Current Year | 249348797 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3057857 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2421140 | RevenuesLessExpensesCY |
| Total Assets BOY | 324301265 | TotalAssetsBOY |
| Total Assets EOY | 360387748 | TotalAssetsEOY |
| Total Liabilities BOY | 162439194 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 194567631 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 161862071 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 165820117 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO ENHANCING THE HEALTH STATUS OF THE INDIVIDUALS AND COMMUNITIES WE SERVE IN PARTNERSHIP WITH OUR PHYSICIANS, EMPLOYEES, AND COMMUNITY MEMBERS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 216433991 | Expense |
| Grants | 80517 | Grants |
| Revenue | 228621644 | Revenue |
| Description | THE HOSPITAL WAS INVOLVED IN A LARGE NUMBER OF COMMUNITY CARE PROJECTS, EITHER AS A PARTICIPANT OR A SPONSORING ORGANIZATION. THESE INCLUDE, BUT ARE NOT LIMITED TO: HEALTHY PREGNANCY, WOMEN'S HEALTHY HEART, NUTRITION, WEIGHT LOSS, HEALTHY AGING, CHILD SAFETY, HEALTH RISK APPRAISALS, SMOKING CESSATION, MANAGING STRESS, CPR, SLEEP DISORDER AND MEN'S HEALTH CLASSES FOR THE COMMUNITY. IN ADDITION, FREE BLOOD PRESSURE SCREENINGS ARE MADE AVAILABLE TO THE COMMUNITY. A BEREAVEMENT PROGRAM IS OFFERED THROUGH THE OBSTETRICS DEPT FOR GRIEVING PARENTS OF INFANTS. ANNUALLY, VOLUNTEERS FROM THE HOSPITAL PARTICIPATE AT THE ROCHESTER ARTS AND APPLES FESTIVAL, COLLECT GIFTS FOR THE ROCHESTER NEIGHBORHOOD HOUSE, COLLECT FOOD FOR THE MICHIGAN HARVEST GATHERING AND PARTICIPATE IN THE NORTH OAKLAND AMERICAN HEART WALK, THE BROOKSIE WAY AND COATS FOR COLD. A GEROPSYCHIATRIC PROGRAM WAS STARTED TO ASSIST OLDER ADULTS WITH HEALTH CARE CHANGES AND THE HOSPITAL ALSO HAS WOUND CARE SERVICES, INCLUDING HYPERBARIC TREATMENTS. | Description |
| Total Program Service Expense | 216433991 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 264 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1918 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIM HAUSCHILD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2486525780 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY DRIVE | AddressLine1 |
| City | ROCHESTER | City |
| State | MI | State |
| ZIP Code | 48307 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| BEVERLY ALLEN | ||||||||
| VICE CHAIRMAN AND TREASURER | 1.00 | 0.00 | X | X | 0 | 0 | 0 | |
| LISA ASADOORIAN | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| BRYAN BARNETT | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| MICHAEL BROWE | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| PETER DESTEIGER | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| ROBERT GO MD | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 34593 | 0 | 0 | ||
| KENNETH JOHNSON | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| KATHRIN KUDNER | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| ROBERT LENIHAN II | ||||||||
| CHAIRMAN | 1.00 | 0.00 | X | X | 0 | 0 | 0 | |
| FREDERICK MAIBAUER MD | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| RUSSELL SHELTON | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| F SCOTT MILLER | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| ROBERT SKANDALARIS | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| BRAD UPTON | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| LYNN ORFGEN | ||||||||
| CEO | 39.00 | 1.00 | X | 550861 | 0 | 38173 | ||
| AUDRIANNE MOCERI | ||||||||
| SECRETARY | 40.00 | 0.00 | X | 61332 | 0 | 17123 | ||
| JEFFREY JENNINGS MD | ||||||||
| CHIEF OF STAFF | 1.00 | 0.00 | X | 50000 | 0 | 0 | ||
| FRANK SOTTILE MD | ||||||||
| INTERIM CHIEF EXECUTIVE OFFICER | 36.00 | 4.00 | X | 396871 | 0 | 39161 | ||
| GREGORY PARTAMIAN | ||||||||
| COO | 40.00 | 0.00 | X | 219282 | 0 | 41189 | ||
| KATHLEEN VANWAGONER | ||||||||
| CNO | 40.00 | 0.00 | X | 156416 | 0 | 37062 | ||
| MICHELLE HORNBERGER | ||||||||
| CSO | 27.00 | 13.00 | X | 157528 | 0 | 34189 | ||
| DONNA KOPINSKI | ||||||||
| CFO | 34.00 | 6.00 | X | 173013 | 0 | 39430 | ||
| SAMAR KAZZIHA MD | ||||||||
| EXECUTIVE MEDICAL DIRECTOR | 40.00 | 0.00 | 466252 | 0 | 19846 | X | ||
| DOUGLAS PUGMIRE DO | ||||||||
| MEDICAL DIRECTOR ROBOTICS/GYNOCOLOGY | 40.00 | 0.00 | 675218 | 0 | 21615 | X | ||
| KEVIN FLOREK DO | ||||||||
| MEDICAL DIRECTOR OCCUPATIONAL MEDICINE | 40.00 | 0.00 | 266029 | 0 | 39937 | X | ||
| CHRISTOPHER PICHETTE | ||||||||
| CRNA | 40.00 | 0.00 | 189072 | 0 | 30799 | X | ||
| SHERYL MAY | ||||||||
| CRNA | 40.00 | 0.00 | 193170 | 0 | 28702 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3589637 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 387226 | TotalOtherCompensation |
| Number Individuals GT100 K | 88 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BARTON MALOW-REWOLD LLC | |||||
| 26500 AMERICAN DR | SOUTHFIELD | MI | 48034 | CONSTRUCTION MANAGEMENT | 24848330 |
| UNASOURCE SURGERY CENTERLLC | |||||
| 4550 INVESTMENT DR STE 100 | TROY | MI | 48098 | SURGICAL SERVICES | 5987052 |
| CERNER HEALTHCARE SOLUTIONS | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | IT SERVICES | 2426798 |
| PATRIOT MEDICAL TECHNOLOGIES | |||||
| PO BOX 415000 | NASHVILLE | TN | 37241 | BIOMEDICAL SERVICES | 2351240 |
| BALD MOUNTAIN SURGICAL CENTER LLC | |||||
| 1375 S LAPEER RD STE 109 | LAKE ORION | MI | 48360 | SURGICAL SERVICES | 1884717 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 69 | NumberOfContractorsGT100K |
| Related Organizations | 11183811 | RelatedOrganizations |
| All Other Contributions | 14571 | AllOtherContributions |
| Total Contributions | 11198382 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | 228660558 | 224454608 | 4205950 |
| E.H.R INCENTIVE | 900099 | 2917340 | 2917340 | |
| INVESTMENT IN JOINT VENTURES | 900099 | 1215658 | 766829 | 448829 |
| SPORTS REHABILITATION CENTER | 900099 | 162912 | 162912 | |
| CPR CLASSES | 611600 | 122064 | 122064 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 197891 | TotalRevenueColumn |
| Related Or Exempt Function Income | 197891 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 233276423 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2913173 | TotalRevenueColumn |
| Exclusion | $2,913,173 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 90266558 | Securities |
| Other | 90749208 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 86585443 | Securities |
| Other | 91780730 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3681115 | Securities |
| Other | -1031522 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2649593 | TotalRevenueColumn |
| Exclusion | $2,649,593 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 42838 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 30830 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12008 | TotalRevenueColumn |
| Exclusion | $12,008 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 216627 | GrossSalesOfInventory |
| Cost Of Goods Sold | 128352 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 88275 | TotalRevenueColumn |
| Exclusion | $88,275 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MRI AND LAND LEASE | 900099 | 313933 | $313,933 |
| MEDICAL STAFF FUNCTIONS | 900099 | 233789 | $233,789 |
| TV RENTAL | 900099 | 225866 | $225,866 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 858495 | TotalRevenueColumn |
| Unrelated Business Revenue | 4488 | UnrelatedBusinessRevenue |
| Exclusion | $854,007 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1632083 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 251769937 | TotalRevenueColumn |
| Related Or Exempt Function Income | 228621644 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 4659267 | UnrelatedBusinessRevenue |
| Exclusion | $7,290,644 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80517 | Total |
| Program Services | 80517 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1967769 | Total |
| Management And General | 1967769 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84106404 | Total |
| Program Services | 78850881 | ProgramServices |
| Management And General | 5255523 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4801786 | Total |
| Program Services | 4368665 | ProgramServices |
| Management And General | 433121 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9414451 | Total |
| Program Services | 8572257 | ProgramServices |
| Management And General | 842194 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6752312 | Total |
| Program Services | 6143253 | ProgramServices |
| Management And General | 609059 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 392542 | Total |
| Program Services | 78000 | ProgramServices |
| Management And General | 314542 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 396075 | Total |
| Management And General | 396075 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86878 | Total |
| Management And General | 86878 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55000 | Total |
| Management And General | 55000 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68746 | Total |
| Management And General | 68746 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43089858 | Total |
| Program Services | 40632242 | ProgramServices |
| Management And General | 2457616 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1234692 | Total |
| Program Services | 21502 | ProgramServices |
| Management And General | 1213190 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3828591 | Total |
| Program Services | 2219843 | ProgramServices |
| Management And General | 1607891 | ManagementAndGeneral |
| Fundraising | 857 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8276157 | Total |
| Program Services | 13500 | ProgramServices |
| Management And General | 8262657 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5022829 | Total |
| Program Services | 2205567 | ProgramServices |
| Management And General | 2817262 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119490 | Total |
| Program Services | 61907 | ProgramServices |
| Management And General | 57583 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37456 | Total |
| Program Services | 24017 | ProgramServices |
| Management And General | 11292 | ManagementAndGeneral |
| Fundraising | 2147 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2754594 | Total |
| Program Services | 2754594 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14797679 | Total |
| Program Services | 9652330 | ProgramServices |
| Management And General | 5145349 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167297 | Total |
| Program Services | 134502 | ProgramServices |
| Management And General | 32795 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 38739129 | 38739129 | |
| BAD DEBT EXPENSE | 11607188 | 11607188 | |
| QAAP EXPENSE | 6760463 | 6760463 | |
| MALPRACTICE | 1604718 | 1476540 | 128178 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3186176 | Total |
| Program Services | 2037094 | ProgramServices |
| Management And General | 1148939 | ManagementAndGeneral |
| Fundraising | 143 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249348797 | Total |
| Program Services | 216433991 | ProgramServices |
| Management And General | 32911659 | ManagementAndGeneral |
| Fundraising | 3147 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12685 | BOY |
| EOY | 12150 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17990817 | BOY |
| EOY | 19481844 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41194946 | BOY |
| EOY | 34835056 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3928146 | BOY |
| EOY | 4014091 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2471594 | BOY |
| EOY | 2501446 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 346133660 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 180947625 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 145727508 | BOY |
| EOY | 165186035 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78648873 | BOY |
| EOY | 75938408 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47846 | BOY |
| EOY | 41658 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11249473 | BOY |
| EOY | 11329522 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23029377 | BOY |
| EOY | 47047538 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 324301265 | BOY |
| EOY | 360387748 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28784304 | BOY |
| EOY | 31931100 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 188000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98610000 | BOY |
| EOY | 128567572 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1595841 | BOY |
| EOY | 858157 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17500 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33431549 | BOY |
| EOY | 33022802 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 162439194 | BOY |
| EOY | 194567631 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161034469 | BOY |
| EOY | 165653010 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 827602 | BOY |
| EOY | 167107 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161862071 | BOY |
| EOY | 165820117 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 324301265 | BOY |
| EOY | 360387748 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2421140 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 4019838 | ReconciliationUnrealizedInvest |
| Reconcilation Prior Adjustment | 367 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | -2483299 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $55,000 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 55000 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | CRITTENTON HOSPITAL MEDICAL CENTER INDIRECTLY CONDUCTS LOBBYING ACTIVITIES THROUGHOUT THE YEAR. THE HOSPITAL HAS ENGAGED THE SERVICES OF A PROFESSIONAL LOBBYIST, WHO PERIODICALLY MEETS WITH FEDERAL, STATE, AND LOCAL LEGISLATORS TO DISCUSS ITEMS OF IMPORTANCE TO THE HOSPITAL AND HEALTH CARE INDUSTRY, AND ISSUES AFFECTING THE HEALTH CARE NEEDS OF THE COMMUNITY. THE EXPENDITURES LISTED IN PART II-B ARE FEES AND EXPENSE REIMBURSEMENTS PAID TO THE LOBBYIST DURING THE YEAR. ON RARE OCCASIONS, THE HOSPITAL ENCOURAGES ITS EMPLOYEES TO CONTACT LEGISLATORS TO CONSIDER CHANGES IN THE LAW THAT WOULD IMPROVE THE REGULATORY CLIMATE AFFECTING THE HEALTH CARE INDUSTRY AND ULTIMATELY, HEALTH CARE NEEDS OF THE COMMUNITY THE HOSPITAL SERVES. THE "GRASSROOT" LOBBYING IS INFREQUENT, AND INVOLVES NO SIGNIFICANT EXPENDITURES BY EITHER THE HOSPITAL OR ITS EMPLOYEES. NONE OF THIS ACTIVITY (DIRECT OR INDIRECT) INVOLVES POLITICAL CAMPAIGN ACTIVITY. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 827601 | BeginningOfYearBalance |
| Contributions | 193472 | Contributions |
| Investment Earnings Or Losses | 7886 | InvestmentEarningsOrLosses |
| Other Expenditures | 885577 | OtherExpenditures |
| Administrative Expenses | 5237 | AdministrativeExpenses |
| End Of Year Balance | 138145 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 843841 | BeginningOfYearBalance |
| Contributions | 219377 | Contributions |
| Investment Earnings Or Losses | 12055 | InvestmentEarningsOrLosses |
| Other Expenditures | 243647 | OtherExpenditures |
| Administrative Expenses | 4025 | AdministrativeExpenses |
| End Of Year Balance | 827601 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 964434 | BeginningOfYearBalance |
| Contributions | 167277 | Contributions |
| Investment Earnings Or Losses | 17908 | InvestmentEarningsOrLosses |
| Other Expenditures | 295562 | OtherExpenditures |
| Administrative Expenses | 10216 | AdministrativeExpenses |
| End Of Year Balance | 843841 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1026646 | BeginningOfYearBalance |
| Contributions | 152319 | Contributions |
| Investment Earnings Or Losses | 19315 | InvestmentEarningsOrLosses |
| Other Expenditures | 218961 | OtherExpenditures |
| Administrative Expenses | 14885 | AdministrativeExpenses |
| End Of Year Balance | 964434 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1062921 | BeginningOfYearBalance |
| Contributions | 168931 | Contributions |
| Investment Earnings Or Losses | 15719 | InvestmentEarningsOrLosses |
| Other Expenditures | 203894 | OtherExpenditures |
| Administrative Expenses | 17031 | AdministrativeExpenses |
| End Of Year Balance | 1026646 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2565744 | OtherCostOrOtherBasis |
| Book Value | 2565744 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 182222072 | OtherCostOrOtherBasis |
| Depreciation | 94043249 | Depreciation |
| Book Value | 88178823 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1732459 | OtherCostOrOtherBasis |
| Depreciation | 956777 | Depreciation |
| Book Value | 775682 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 113242282 | OtherCostOrOtherBasis |
| Depreciation | 83516993 | Depreciation |
| Book Value | 29725289 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 46371103 | OtherCostOrOtherBasis |
| Depreciation | 2430606 | Depreciation |
| Book Value | 43940497 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 165186035 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (16 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ACCOUNTS RECEIVABLE AFFILIATES | 16658727 |
| MISCELLANEOUS ACCOUNTS RECEIVABLE | 997073 |
| ACCOUNTS RECEIVABLE POWERWORKS | 79025 |
| DEBT ISSUANCE COST | 2046586 |
| ACCOUNTS RECEIVABLE KARMANOS | 585653 |
| ACCOUNTS RECEIVABLE SAAC | 5968106 |
| DUE FROM THIRD PARTY | 4144291 |
| PHYSICIAN LOAN FOREGIVENESS | 571526 |
| PHYSICIAN LOANS | 579243 |
| LOAN RECEIVABLE DOCTORS HOSPITAL | 2654116 |
| CONTRUCTION FUND 2012A | 788629 |
| FUNDS HELD BY TRUSTEE, LESS CURRENT | 7100735 |
| ACCOUNTS RECEIVABLE KIRKO | 1865005 |
| ACCOUNTS RECEIVABLE RHREH | 422922 |
| ACCOUNTS RECEIVABLE RREH | 1850901 |
| MALPRACTICE GROSS UP | 735000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 47047538 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| SELF FUNDED MALPRACTICE INS CLAIMS LIABILITY | $4,116,329 |
| POST RETIREMENT HEALTH INS LIABILITY | $389,801 |
| PENSION LIABILITY | $28,516,672 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 33022802 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENT FUNDS ARE USED FOR THE GIFT SHOP, THE AUXILLIARY AND THE HOSPITAL FOR GRANTS, SCHOLARSHIPS AND OTHER EXPENSES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)
| RegionRegion | Number Of OfficesNumberOfOffices | Number Of EmployeesNumberOfEmployees | Type Of Activities ConductedTypeOfActivitiesConducted | Specific Services ProvidedSpecificServicesProvided | Total ExpendituresTotalExpenditures |
|---|---|---|---|---|---|
| CENTRAL AMERICA/CARIBBEAN | 0 | 0 | PROGRAM SERVICES | INSURANCE | 903256 |
| CENTRAL AMERICA/CARIBBEAN | 0 | 0 | INVESTMENT | 161658 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 1064914 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 1064914 | TotalAmountSpent |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SHOE SALE | NameOfEvent1 |
| Gross Receipts Event1 | 10570 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 10570 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 4676 | OtherDirectExpensesEvent1 |
| Name Of Event2 | $6 SALE | NameOfEvent2 |
| Gross Receipts Event2 | 9902 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 9902 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 6465 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 13 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 22366 | GrossReceiptsOtherEvents |
| Gross Revenue Other Events | 22366 | GrossRevenueOtherEvents |
| Other Direct Expenses Other Events | 19689 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 42838 | GrossReceiptsTotal |
| Gross Revenue Total Events | 42838 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 30830 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 30830 | DirectExpenseSummaryEvents |
| Net Income Summary | 12008 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 703057 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 703057 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00300 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20484012 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15720860 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4763152 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02000 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 418366 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 335900 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 82466 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21605435 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16056760 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5548675 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02330 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 174533 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 174533 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10315040 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2585429 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7729611 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03250 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 88647 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 88647 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10578220 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2585429 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7992791 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03360 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 32183655 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18642189 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13541466 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05690 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 269 | PersonsServed |
| Total Community Building Expense | 560 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 560 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 512 | PersonsServed |
| Total Community Building Expense | 25963 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 25963 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 85 | NumberOfActivitiesOrPrograms |
| Persons Served | 1580 | PersonsServed |
| Total Community Building Expense | 49865 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 49865 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 102 | NumberOfActivitiesOrPrograms |
| Persons Served | 2361 | PersonsServed |
| Total Community Building Expense | 76388 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 76388 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $11,607,188 | BadDebtExpenseAmount |
| Amount Attributable To | 1966246 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 68928916 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 77044417 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8115501 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 USC LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | SURGICAL CENTER | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.30340 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.69660 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | CRITTENTON HOSPITAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY | AddressLine1 |
| City | ROCHESTER | City |
| State | MI | State |
| ZIP Code | 48307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENTON HOSPITAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 250.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| USC LLC | ||||
| 4800 INVESTMENT DRIVE STE 370 | TROY | MI | 48098 | SURGICAL CENTER |
| MICHIGAN RESONANCE IMAGING | ||||
| 355 BARCLAY CIRCLE STE A | ROCHESTER | MI | 48307 | IMAGING CENTER |
| MICHIGAN MOBILE PET | ||||
| 15500 LUNDY PARKWAY | DEARBORN | MI | 48126 | IMAGING CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: CRITTENTON HOSPITAL MEDICAL CENTER USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILTY FOR PROVIDING BOTH 'FREE' CARE AND 'DISCOUNTED' CARE TO LOW INCOME INDIVIDUALS. THE FAMILY INCOME LIMIT USED IS 200% FOR 'FREE' CARE AND 250% FOR 'DISCOUNTED' CARE. | ||
| PART I, LINE 7: THE COSTING METHOD USED FOR FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMS WAS A COST TO CHARGE RATIO FROM WORKSHEET 2 AND OTHER COMMUNITY BENEFITS WAS CALCULATED BASED UPON ACTUAL COST. | ||
| PART I, LINE 7G: CRITTENTON HOSPITAL MEDICAL CENTER DOES NOT HAVE ANY SUBSIDIZED HEALTH SERVICES TO REPORT. | ||
| PART I, L7 COL(F): THE BAD DEBT EXPENSE OF $11,607,188 WAS REMOVED FROM THE DENOMINATOR FOR THE CALCULATION OF THE PERCENT OF TOTAL EXPENSE. | ||
| PART II: COMMUNITY HEALTH LEADERSHIP AND OTHER SENIOR LEADERS ACTIVELY PARTICIPATE ON A BROAD RANGE OF COMMUNITY COALITIONS SUCH AS THE OLDER PERSON'S COMMISSION, ROCHESTER COMMUNITY SCHOOLS, ROCHESTER/AUBURN HILLS COMMUNITY COALITION, OAKLAND COUNTY OBESITY COALITION, REGION 2 NORTH, OAKLAND COUNTY MEDICAL CONTROL AUTHORITY, MICHIGAN DEPT OF COMMUNITY HEALTH, CROSSROADS PREGNANCY CENTER AND OTHERS. THIS PROVIDES ONGOING KNOWLEDGE OF VARYING COMMUNITY NEEDS AND ADJUSTS AS ECONOMIC, ENVIRONMENTAL, AND HEALTHCARE CHANGES OCCUR IN CRITTENTON'S KEY COMMUNITIES.THE VARIOUS PROGRAMS THAT CHMC OFFERS TO THE COMMUNITY HELP TO ENHANCE THE HEALTH STATUS BY EDUCATION, EARLY DETECTION, SCREENING, AND ACCESSIBILITY TO RESOURCES. WE RECEIVE MULTIPLY STORIES EVERY YEAR STATING THAT IF THEY HAD NOT HAD ATTENDED ONE OF OUR SCREENINGS THEN THEY MAY NOT HAVE PURSUED FURTHER MEDICAL CARE OR TREATMENT. THE SCREENING OR EDUCATION IS WHAT INCREASED THEIR AWARENESS AND ENCOURAGED THEM TO SEEK CARE AND THAT SCREENING OR ACTIVITY IS WHAT HELPED TO ENHANCE THEIR HEALTH. | ||
| PART III, LINE 4: PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. THE BAD DEBT AMOUNT REPORTED ON PART III LINE 2 IS BAD DEBT EXPENSE PER THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS AND PER FORM 990 PART IX. PART III, LINE 3: THE HOSPITAL FOLLOWS THE POLICY OF PROVIDING HEALTH SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. CONSEQUENTLY, THE HOSPITAL PROVIDES HEALTH SERVICES FREE OF CHARGE OR AT AMOUNTS LESS THAN ITS FULL COSTS OF PROVIDING CARE TO CERTAIN CATEGORIES OF PATIENTS. THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED USING THE HISTORICAL PERCENTAGE BASED ON CHARITY CARE APPLICATIONS APPROVED. | ||
| PART III, LINE 8: AS A NON-PROFIT HOSPITAL, CRITTENTON HOSPITAL MEDICAL CENTER IS REQUIRED TO PROVIDE MINIMAL LEVELS OF COMMUNITY BENEFIT IN EXCHANGE FOR OUR TAX EXEMPT STATUS. THESE COMMUNITY BENEFITS INCLUDE HEALTH EDUCATION OPPORTUNITIES, CHARITY AND BAD DEBT WRITEOFFS, AND OUR LOSSES ON MEDICARE. IN KEEPING WITH OUR MISSION TO PROMOTE HEALTH IN THE COMMUNITY, WE PROVIDE CARE TO MEDICARE BENEFICIARIES AT A LOSS, THUS HELPING TO RELIEVE THE GOVERNMENT BURDEN OF TREATING THESE PATIENTS WHO MAY OTHERWISE HAVE THEIR ACCESS TO CARE LIMITED. | ||
| PART III, LINE 9B: IT IS THE POLICY OF CRITTENTON HOSPITAL MEDICAL CENTER TO REQUIRE PAYMENT IN FULL FOR ALL SERVICES RENDERED, WHICH ARE PATIENT PAY, UPON RECEIPT OF THEIR FIRST STATEMENT. THE PATIENT THEN HAS THIRTY DAYS TO REMIT PAYMENT IN FULL. THE BURDEN OF PROOF OF A PATIENT'S INABILITY TO PAY IN FULL IS THE RESPONSIBILITY OF THE PATIENT. IF THE PATIENT CAN PROVE AN INABILITY TO PAY THEIR DEBT IN FULL, PARTIAL PAYMENT ARRANGEMENTS CAN BE MADE. IT IS ALSO THE POLICY OF THE HOSPITAL TO PROVIDE THE PATIENT WITH INFORMATION REGARDING THE AVAILABILITY OF WHATEVER SOCIAL SERVICES MAY BE APPLICABLE FOR THE PATIENT. IN ADDITION, A CHARITY CARE APPLICATION MAY ALSO BE PROVIDED. | ||
| PART V, SECTION B, LINE 10: THE HOSPITAL TAKES PART AND ASSISTS PATIENTS IN QUALIFYING FOR THE COUNTY INDIGENT HOSPITALIZATION PROGRAM. | CRITTENTON HOSPITAL MEDICAL CENTER | |
| PART V, SECTION B, LINE 11: FINANCIAL COUNSELORS ARE ON SITE AND CONTACTED WHENEVER A PATIENT COMES INTO THE HOSPITAL WITHOUT INSURANCE. THESE COUNSELORS ASSIST THE PATIENTS IN QUALIFYING FOR COUNTY, STATE, FEDERAL OR HOSPITAL ASSISTANCE PROGRAMS. | CRITTENTON HOSPITAL MEDICAL CENTER | |
| PART V, SECTION B, LINE 20D: CRITTENTON HOSPITAL MEDICAL CENTER BILLS BASED UPON THE EMERGENCY ROOM CHARGEMASTER, NOT ON ANY PARTICULAR PAYERS CONTRACTED REIMBURSEMENT RATE. THE HOSPITAL WILL PROVIDE A 25% DISCOUNT TO ANY EMERGENCY ROOM PATIENT THAT REQUIRES ONE. | CRITTENTON HOSPITAL MEDICAL CENTER | |
| PART VI, LINE 2: THE ALLOCATION OF CRITTENTON'S RESOURCES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF COMMUNITY RESIDENTS ARE BASED ON COMMUNITY NEEDS THAT ARE IDENTIFIED BOTH THROUGH THE STRATEGIC PLANNING PROCESS AND THROUGH A YEARLY COMPREHENSIVE REVIEW OF COUNTY, STATE AND FEDERAL HEALTHCARE DATA BY CRITTENTON'S COMMUNITY HEALTH AND EDUCATION DEPARTMENT. COMMUNITY NEEDS INFORMATION IS GATHERED FROM BOTH THE CDC'S NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION BEHAVIORAL RISK FACTOR SURVEILLLANCE SYSTEMS AND THROUGH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH. FOR EXAMPLE, IN 2008 THE NEED FOR A SCHOOL NURSE PROGRAM WAS IDENTIFIED WITH THE ROCHESTER COMMUNITY SCHOOLS. CRITTENTON'S COMMUNITY HEALTH AND EDUCATION DEPARTMENT DEVELOPED AND IMPLEMENTED THE PROGRAM WHICH NOW SERVES 14,000 STUDENTS AND MANAGES 450 MEDICAL MANAGEMENT PROGRAMS. STARTING IN 2009, PARTICIPATION WITH THE ROCHESTER/AUBURN HILLS COALITION RESULTED IN CRITTENTON'S SPONSORING RACHEL'S CHALLENGE, A PROGRAM WHICH PROVIDES SUICIDE PREVENTION AND INTERVENTION AND IMPROVED PEER TO PEER CONFLICT MANAGEMENT SKILLS FOR AREA YOUTH. | ||
| PART VI, LINE 3: CRITTENTON HOSPITAL MEDICAL CENTER DOES A NUMBER OF THINGS IN ORDER TO EDUCATE AND/OR ASSIST A PATIENT IN RECEIVING OUTSIDE ASSISTANCE, INCLUDING THE FOLLOWING:1. SIGNAGE IS POSTED AT REGISTRATION POINTS AROUND THE HOSPITAL REGARDING ASSISTANCE AVAILABLE TO PAY FOR SERVICES AS WELL AS OUR UNCOMPENSATED SERVICES PROGRAM, HANDOUTS ARE GIVEN TO THE PATIENTS AND THE PROGRAM IS OUTLINED ON THE BACK OF EVERY STATEMENT THAT IS SENT TO THE PATIENT.2. FINANCIAL COUNSELORS ARE ON SITE THAT ARE CONTACTED EVERY TIME A PATIENT WITHOUT INSURANCE COMES INTO THE EMERGENCY ROOM OR IS ADMITTED TO THE HOSPITAL. IN THE PAST 12 MONTHS THE FINANCIAL COUNSELORS HAVE ASSISTED MANY PATIENTS IN QUALIFYING FOR COUNTY, STATE, FEDERAL, OR HOSPITAL ASSISTANCE PROGRAMS.3. TAKE PART AND ASSIST PATIENTS IN QUALIFYING FOR THE COUNTY INDIGENT HOSPITATLIZATION PROGRAM WHICH IS RUN DIRECTLY THROUGH THE HOSPITAL AND PLACES VIRTUALLY NO BURDEN OF ANY TYPE ON THE PATIENT IN ORDER TO BE QUALIFIED.4. ALL MANAGERS THAT DEAL WITH THE PUBLIC ARE DIRECTLY INFORMED OF OUR UNCOMPENSATED SERVICE PROGRAMS AND VERBALLY ASSIST PATIENTS WITH SUGGESTIONS AS WELL AS OUR CASHIERS HAVING ACCESS TO THE SAME INFORMATION AND TRAINING. 5. OFFER ASSISTANCE TO NEWBORN MOTHERS WITHOUT INSURANCE IN THE FORM OF ASSISTANCE IN APPLYING FOR MEDICAID AND PROVIDING MINIMAL PAYMENT OPTIONS. | ||
| PART VI, LINE 4: CRITTENTON IS A 290 BED ACUTE CARE HEALTH FACILITY SERVING COMMUNITIES IN OAKLAND, MACOMB, AND LAPEER COUNTIES. THE ENTIRE SERVICE AREA ENCOMPASSES 35 ZIP CODES IN THREE REGIONS AND IS FURTHER SUBDIVIDED INTO THREE SECTORS: OUR CORE SECTOR WHICH ENCOMPASSES THE THREE ROCHESTER ZIP CODES, AND THE PRIMARY AND SECONDARY SECTORS. THE DEMOGRAPHIC SKEW FOR THE AREA IS SLIGHTLY OLDER THAN THE NORM WITH HIGHER HOUSEHOLD INCOMES. | ||
| PART VI, LINE 5: CRITTENTON HOSPITAL MEDICAL CENTER DOES NOT WANT TO FORGET THE IMPORTANT ROLE THE COMMUNITY PLAYS IN ITS SUCCESS. THE HOSPITAL IS ESPECIALLY GRATEFUL THAT THEY ARE ABLE TO GIVE BACK TO THE COMMUNITY THROUGH ESSENTIAL HEALTHCARE SERVICES AND EDUCATION TO CATER TO THE UNMET NEEDS OF SO MANY IN ITS COMMUNITY. OFFERING ADVANCED CARE AND SERVICES IS ONE OF THE MANY WAYS CRITTENTON SERVES ITS COMMUNITY. CRITTENTON HAS PARTNERED WITH PREMIER ORGANIZATIONS TO FULFILL ITS MISSION OF ENHANCING THE HEALTH STATUS OF THE COMMUNITY, I.E. UNIVERSITY OF MICHIGAN, WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE AND OAKLAND UNIVERSITY SCHOOL OF NURSING ARE JUST A FEW. | ||
| PART VI, LINE 6: CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO PROVIDING CARE TO ALL RESIDENTS OF THE COMMUNITY, REGARDLESS OF THEIR FINANCIAL STATUS. THROUGH UNCOMPENSATED CARE, GOVERNMENT SPONSORED HEALTH CARE, COMMUNITY HEALTH SERVICES AND DONATIONS THE HOSPITAL IS ABLE TO REACH OUT TO THE COMMUNITY. THE FOUNDATION IS THE FUNDRAISING ARM OF THE ORGANIZATION. THEY HAVE HOSTED EVENTS SUCH AS THE GOLF, TENNIS AND FUN WALK BENEFIT AND THE GOURMET GALA BENEFIT WHICH HAS RAISED MONEY FOR A VARIETY OF ENHANCEMENTS TO THE HOSPITAL. THE CRITTENTON VOLUNTEER AUXILLARY IS AN INTEGRAL PART OF THE HOSPITAL'S SUCCESS. THE GROUP CONTRIBUTES A GREAT DEAL OF TIME AND SERVICE TO FURTHER THE GOAL OF PROVIDING CLINICAL EXCELLENCE IN A COMFORTABLE, WELCOMING ENVIRONMENT. SOME OF THE SERVICES THAT THEY PROVIDE INCLUDE CLERICAL ASSISTANCE, ESCORTING PATIENTS AROUND THE FACILITY, AND GREETING FAMILIES AND VISITORS. THE CRITTENTON WELLNESS CENTER AND THE OLDER PERSONS COMMISSION HAVE COMBINED HEALTH, WELLNESS, EDUCATION AND ACTIVITIES ALL WITH THE OLDER PERSON IN MIND. MEMBERSHIP IS FREE TO RESIDENTS OF ROCHESTER, ROCHESTER HILLS, AND OAKLAND TOWNSHIP WHO ARE OLDER THAN AGE FIFTY. CRITTENTON CANCER CENTER PROVIDES COMMUNITY MEMBERS WITH A NEW LOCAL RESOURCE OF EXCEPTIONAL CANCER CARE. THE SERVICES PROVIDED BY THE HOSPITAL AT THE CANCER CENTER ARE IMAGING AND RADIATION THERAPY. | ||
| MI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 W UNIVERSITY | AddressLine1 |
| City | ROCHESTER | City |
| State | MI | State |
| ZIP Code | 48307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 382627336 | EINOfRecipient |
| IRC Section | 501(C)3 | IRCSection |
| Amount Of Cash Grant | 80517 | AmountOfCashGrant |
| Purpose Of Grant | TO PROVIDE FINANCIAL SUPPORT AND FURTHER CHARITABLE ENDEAVORS. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| TitleTitle | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LYNN ORFGEN | ||||||||||||||
| CEO | 336546 | 0 | 0 | 0 | 214315 | 0 | 22500 | 0 | 15673 | 0 | 589034 | 0 | 0 | 0 |
| FRANK SOTTILE MD | ||||||||||||||
| INTERIM CHIEF EXECUTIVE OFFICER | 393337 | 0 | 0 | 0 | 3534 | 0 | 22000 | 0 | 17161 | 0 | 436032 | 0 | 0 | 0 |
| GREGORY PARTAMIAN | ||||||||||||||
| COO | 218436 | 0 | 0 | 0 | 846 | 0 | 22000 | 0 | 19189 | 0 | 260471 | 0 | 0 | 0 |
| KATHLEEN VANWAGONER | ||||||||||||||
| CNO | 154233 | 0 | 0 | 0 | 2183 | 0 | 22096 | 0 | 14966 | 0 | 193478 | 0 | 0 | 0 |
| MICHELLE HORNBERGER | ||||||||||||||
| CSO | 157284 | 0 | 0 | 0 | 244 | 0 | 15000 | 0 | 19189 | 0 | 191717 | 0 | 0 | 0 |
| DONNA KOPINSKI | ||||||||||||||
| CFO | 172663 | 0 | 0 | 0 | 350 | 0 | 22500 | 0 | 16930 | 0 | 212443 | 0 | 0 | 0 |
| SAMAR KAZZIHA MD | ||||||||||||||
| EXECUTIVE MEDICAL DIRECTOR | 450372 | 0 | 14000 | 0 | 1880 | 0 | 0 | 0 | 19846 | 0 | 486098 | 0 | 0 | 0 |
| DOUGLAS PUGMIRE DO | ||||||||||||||
| MEDICAL DIRECTOR ROBOTICS/GYNOCOLOGY | 675218 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 21615 | 0 | 696833 | 0 | 0 | 0 |
| KEVIN FLOREK DO | ||||||||||||||
| MEDICAL DIRECTOR OCCUPATIONAL MEDICI | 252453 | 0 | 10000 | 0 | 3576 | 0 | 22100 | 0 | 17837 | 0 | 305966 | 0 | 0 | 0 |
| CHRISTOPHER PICHETTE | ||||||||||||||
| CRNA | 189004 | 0 | 0 | 0 | 68 | 0 | 11610 | 0 | 19189 | 0 | 219871 | 0 | 0 | 0 |
| SHERYL MAY | ||||||||||||||
| CRNA | 192331 | 0 | 0 | 0 | 839 | 0 | 20540 | 0 | 8162 | 0 | 221872 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4A | ReturnReference |
| Explanation | LYNN ORFGEN RECEIVED A SEVERANCE PAYMENT OF $203,320 IN 2012. THERE IS A SEVERANCE AGREEMENT SIGNED BY BOTH THE EMPLOYER AND EMPLOYEE DETAILING THE TERMS. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| MICHIGAN FINANCE AUTHORITY | ||||||||
| A | 382889417 | 59447PSU6 | 2012-11-14 | 113598798 | COSTS OF TOWER PROJECT AND REFUND CERTAIN EXISTING INDEBTEDNESS OF CORP | 0 | 0 | 0 |
| MICHIGAN FINANCE AUTHORITY | ||||||||
| B | 382889417 | 2012-12-01 | 45000000 | COSTS OF TOWER PROJECT | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 113598912 | 7100622 | 92742139 | 1760849 | 11955302 | 2012 | 1 | 0 | 1 | 1 | |
| B | 45000000 | 326050 | 15000000 | 2013 | 0 | 0 | 0 | 1 | 29673950 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 0 |
| B | 0 |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | ISSUE DATE OF THE REFUNDED BONDS: 2002A BONDS 07/11/2002 2003A BONDS 07/30/2003 2003B BONDS 12/23/2003 | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN IS GIVEN TO THE BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW BEFORE FILING. AFTER THE REVIEW, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL POLICY STATES THAT ALL EMPLOYEES HAVE A CONTINUOUS OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST, AN ACTUAL IMPROPRIETY, AND/OR AN APPEARANCE OF IMPROPRIETY. EMPLOYEES AT THE MANAGER LEVEL AND ABOVE EACH SIGN A STATEMENT ON AN ANNUAL BASIS ACKNOWLEDGING THEIR UNDERSTANDING OF THE POLICY AND VERIFYING THEIR APPROPRIATE DISCLOSURE OF ANY CONFLICTS. ALL REPORTED CONFLICTS SHALL BE REVIEWED BY THE CEO IN CONJUCTION WITH THE COMPLIANCE OFFICER AND DEPARTMENT OF LEGAL AFFAIRS. IF IT IS DETERMINED THAT A CONFLICT EXISTS THE EMPLOYEEE SHALL DISCONTINUE ALL ACTIVITIES SURROUNDING THAT CONFLICT. THE EMPLOYEE MAY ALSO SEEK A WAIVER OF THE CONFLICT FROM THE CEO. CHMC ALSO HAS A QUESTIONNAIRE FOR INDIVIDUALS AND THEIR IMMEDIATE FAMILY MEMBERS, INCLUDING BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES REGARDING CONFICTS OF INTEREST AND THIS MUST BE SIGNED BY THE INDIVIDUALS. THE QUESTIONNAIRE INCLUDES THE FOLLOWING: 1. IDENTIFY YOUR SERVICE ON ANY BOARD OF DIRECTORS OR TRUSTEES OF ANY OF THE COMPANY'S WITH WHICH CHMC OR ANY OF ITS' AFFILIATES DOES BUSINESS. 2. IDENTIFY WHETHER YOU ARE ASSOCIATED DIRECTLY OR INDIRECTLY OR HOLD A POSITION OR FINANCIAL INTEREST IN ANY OUTSIDE ORGANIZATION OR CONCERN WITH WHICH CRITTENTON DOES BUSINESS. 3. IDENTIFY WHETHER YOU DIRECT, MANAGE,OR PROVIDE SERVICES OR CONSULTATION TO ANY OUTSIDE ORGANIZATION OR CONCERN THAT DOES BUSINESS WITH OR COMPETES WITH CRITTENTON. 4. IDENTIFY ANY ACTIVITIES IN WHICH YOU ARE ENGAGED THAT MIGHT BE REGARDED AS CONSTITUTING A POTENTIAL CONFLICT OF INTEREST WITH CRITTENTON. 5. DISCLOSE ANY DIRECT OR INDIRECT COMPENSATION THAT YOU RECEIVE, OR ANTICIPATE RECEIVING, FROM ANY PERSON, FIRM, CORPORATION, OR MARKET IN ANY WAY RELATED TO YOUR POSITION WITH CRITTENTON. IF AT ANY TIME THERE IS A MATTER UNDER CONSIDERATION WHICH MAY CREATE A DIRECT OR INDIRECT CONFLICT OF INTEREST, IT IS THE INDIVIDUAL'S OBLIGATION TO DISCLOSE THE FACTS SURROUNDING THE POSSIBLE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER OR DEPARTMENT OF HUMAN RESOURCES AND THAT THE INDIVIDUAL AGREES TO PROMPTLY REPORT ANY NEW SITUATIONS THAT REQUIRE DISCLOSURE UNDER THIS QUESTIONNAIRE. THERE IS A SIGNED WRITTEN AGREEMENT/DOCUMENTATION FOR ANY BOARD MEMBER OR OFFICER IF A CONFLICT OF INTEREST ARISES. CURRENTLY THERE HAVE NOT BEEN ANY RESTRICTIONS PLACED ON ANY BOARD MEMBER OR OFFICER AS AN ISSUE HAS NOT ARISEN TO WARRANT THIS. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE AUDIT COMMITTEE REVIEWS THE PERFORMANCE AGAINST THE GOALS SET FOR THE CEO. IN ADDITION THE AUDIT COMMITTEE PERFORMS A REVIEW OF THE TOTAL SALARY AGAINST MARKET STATISTICS. FROM THAT REVIEW, A RECOMMENDATION IS MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD AND THE BOARD FOR APPROVAL. THE DETERMINATION AND DECISION ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE OF THE BOARD MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN 2012. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST OF THE INDIVIDUAL. | |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 406,308. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 406,308. CONTRACT PHYSICIANS: PROGRAM SERVICE EXPENSES 11,688,621. MANAGEMENT AND GENERAL EXPENSES 173,392. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,862,013. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 927,616. MANAGEMENT AND GENERAL EXPENSES 373,254. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,300,870. GROUNDS MAINTENANCE: PROGRAM SERVICE EXPENSES 39,450. MANAGEMENT AND GENERAL EXPENSES 152,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 191,703. PURCHASED SERVICES - MEDICAL & GENERAL: PROGRAM SERVICE EXPENSES 5,236,902. MANAGEMENT AND GENERAL EXPENSES 1,536,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,773,506. CONTRACTED SERVICES - CLERICAL & OTHER: PROGRAM SERVICE EXPENSES 1,245,478. MANAGEMENT AND GENERAL EXPENSES 50,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,295,761. DIETARY & OTHER SERVICES: PROGRAM SERVICE EXPENSES 2,596,935. MANAGEMENT AND GENERAL EXPENSES 171,679. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,768,614. CONTRACT SERVICES-CLINICAL: PROGRAM SERVICE EXPENSES 1,128,490. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,128,490. HOUSEKEEPING & LAUNDRY: PROGRAM SERVICE EXPENSES 4,372,444. MANAGEMENT AND GENERAL EXPENSES 151. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,372,595. PHARMACY: PROGRAM SERVICE EXPENSES 538,691. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 538,691. REHAB: PROGRAM SERVICE EXPENSES 1,107,205. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,107,205. OP SURGICAL SERVICES: PROGRAM SERVICE EXPENSES 8,096,009. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,096,009. PYSCHOLOGY: PROGRAM SERVICE EXPENSES 746,431. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 746,431. BIOMEDICAL: PROGRAM SERVICE EXPENSES 1,671,257. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,671,257. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 830,405. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 830,405. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | PENSION LIABILITY -1,834,304. TEMPORARILY RESTRICTED FUNDS TRANSFER TO RELATED ORGANIZATION -530,634. NET ASSETS RELEASED FROM RESTRICTIONS -118,361. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION DID NOT MAKE ANY SIGNIFICANT CHANGES IN THE PROCESS OF THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION | ||||||||||
| 1101 W UNIVERSITY DR | ROCHESTER | MI | 48307 | 382627336 | SUPPORTING | MI | 501(C)(3) | LINE 11A, I | CRITTENTON HOSPITAL MEDICAL CENTER | 1 |
| CRITTENTON CANCER CENTER | ||||||||||
| 1101 W UNIVERSITY DR | ROCHESTER | MI | 48309 | 383239057 | SUPPORTING | MI | 501(C)(3) | LINE 9 | CRITTENTON HOSPITAL MEDICAL CENTER | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| CRITTENTON MEDICAL EQUIPMENT | |||||||
| 161 S LIVERNOIS RD | ROCHESTER HILLS | MI | 48307 | 383433794 | MEDICAL EQUIPMENT SALES | MI | N/A |
| HBC INFUSIONS | |||||||
| 1101 W UNIVERSITY | ROCHESTER | MI | 48307 | 753123093 | INFUSION SERVICES | MI | N/A |
| BALD MOUNTAIN SURGICAL CENTER | |||||||
| 1375 S LAPEER RD STE 3109 | LAKE ORION | MI | 48360 | 030444972 | SURGICAL SERVICES | MI | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CRITTENTON DEVELOPMENT CORPORATION | ||||||||||||
| 2251 N SQUIRREL RD STE 310 | AUBURN HILLS | MI | 48326 | 382594115 | REAL ESTATE | MI | CRITTENTON HOSPITAL MEDICAL CENTER | C | 446764 | 18012068 | 1.00000 | 0 |
| CRITTENTON MEDICAL PHARMACY | ||||||||||||
| 1101 W UNIVERSITY | ROCHESTER | MI | 48307 | 203773341 | PHARMACY SALES | MI | CRITTENTON DEVELOPMENT CORPORATION | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| CHMC FOUNDATION | ||
| C | 11183811 | ACTUAL CASH TRANSFERRED |
| CHMC FOUNDATION | ||
| B | 80517 | ACTUAL CASH TRANSFERRED |
| CHMC FOUNDATION | ||
| M | 333109 | ACTUAL COST INCURRED |
| CHMC FOUNDATION | ||
| L | 134516 | ACTUAL COST INCURRED |
| CHMC FOUNDATION | ||
| Q | 592097 | ACTUAL COST INCURRED |
| CHMC FOUNDATION | ||
| R | 530634 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| J | 153000 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| O | 274787 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| P | 80644 | ACTUAL COST INCURRED |
| CRITTENTON CANCER CENTER | ||
| D | 16309667 | ACTUAL COST INCURRED |
Comments