2012-11-06T19:07:44-05:00 2011-12-31 990 2011-01-01 383426063 CARO COMMUNITY HOSPITAL CARO 401 N HOOPER ST PO BOX 435 CARO MI 48723 WILLIAM P MILLER 9896733141 2012-11-06 2011 2016-02-25 16:41:14Z WILLIAM P MILLER 13227544 false X WWW.CCH-MI.ORG X 1999 MI CARO COMMUNITY HOSPITAL A COMMUNITY-MINDED HEALTHCARE SYSTEM IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE 7 5 197 57 0 0 28433 11012 13828051 12964413 36889 94093 94030 108905 13987403 13178423 0 0 7845505 7548067 0 0 6570682 6343002 14416187 13891069 -428784 -712646 7933659 7208747 4618763 4556335 3314896 2652412 CARO COMMUNITY HOSPITAL A COMMUNITY-MINDED HEALTHCARE SYSTEM IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE false false 10945278 PROVISION OF NEEDED MEDICAL SERVICES TO THE COMMUNITY 10945278 true false false false false false false false true true false false true true false false false false false false false false false false false true true false false true false false false true false false false true false false false false false true false false false false true 31 0 true 197 true false false false false false false false false false false false false false false X 7 5 false false false false false false false true true false false true true true true false false true false false false MI X X RONALD D SREBINSKI CFO 9896733141 401 N HOOPER STREET PO BOX 435 CARO MI 487230435 DALE PERZ 16.00 X X 60300 0 0 DAN BRISTOL 2.00 X X 0 0 0 DON DUGGAR 2.00 X 0 0 0 DR AFONSO FERREIRA 2.00 X 0 0 0 LYNN LAETHEM 2.00 X X 0 0 0 RUBY REID 2.00 X 0 2570 0 WILLIAM P MILLER 40.00 X X X X 154577 0 33205 DR JULIE SAWADE 40.00 X 180261 34193 DR RICHARD MOYER 32.00 X 220135 40427 SUE MORRIS 40.00 X 116441 15763 731714 2570 123588 4 false true false HOSPITAL MD 200 W PARK DRIVE STE 325 PEACHTREE CITY GA 30269 E R PHYSICIANS 1095000 1 11012 11012 NET PATIENT SERVICE REV 900099 12964413 12964413 12964413 94093 94093 35370 43532 -8162 -8162 -8162 11965 5589 6376 6376 CAFETERIA 722210 14272 14272 HPSA PAYMENTS 900099 24445 24445 71974 71974 110691 13178423 13073318 0 94093 154577 154577 5154189 4029577 1124612 183605 138177 45428 1662756 1262102 400654 392940 296199 96741 77386 77386 31000 31000 1369738 1369738 52426 52426 30301 30301 554693 502573 52120 36159 13325 22834 142786 142786 616606 430743 185863 142675 142675 SUPPLY COSTS 1413492 1362891 50601 DUES AND SUBSCRIPTIONS 101721 13579 88142 PROVISION FOR BAD DEBTS 891350 891350 PURCHASED SERVICES 501757 319925 181832 380912 29638 351274 13891069 10945278 2945791 0 802378 253998 1117800 1268075 363055 335500 35052 50426 12260265 7438996 5126057 4821269 489317 479479 7933659 7208747 960379 1154297 2427008 2090495 1231376 1311543 4618763 4556335 X 3304896 2647412 5000 5000 5000 3314896 2652412 7933659 7208747 X -712646 50162 X true false true X false X 5000 5000 5000 5000 false true true 133521 133521 5624246 2444959 3179287 12112 10895 1217 6461943 4983142 1478801 28443 28443 4821269 INT IN CCH ENDOWMENT FOUNDATIO 474479 ASSETS LIMITED AS TO USE 5000 479479 ACCOUNT PAYABLE TO THIRD PARTI 618474 ACCRUED AND OTHER LIABILITIES 693069 1311543 Other revenues non included on Form 990 Part XII line 2d EXPENSES RELATING TO RENTAL COST OFFSET 43532 ON LINE 6B PART VIII EXPENSES RELATING TO AUXILIARY GIFT SHOP OFFSET 55589 ON LINE 10B PART VIII 02 Other revenues included on Form 990 Part XII line 4b INTEREST INCOME 94093 CONTRIBUTIONS 11012 03 Other expenses not included on Form 990 Part XIII line 2d EXPENSES RELATING TO RENTAL COST OFFSET 43532 true true true X true X true true false false 4116 4116 0.00030 1830833 769566 1061267 0.07990 1834949 769566 1065383 0.0802 160473 160473 0.0121 160473 160473 0.0121 1995422 769566 1225856 0.0923 true 602107 136775 5126295 5126295 X true true 1 1 CARO COMMUNITY HOSPITAL

401 N HOOPER STREET CARO MI 48723

X X X X CARO COMMUNITY HOSPITAL 1 false false true false true true X X false X X true X X X X true X false 01 Other charity care criteria description Part I line 3c THE HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CHARITY CARE SERVICES 02 Related organization annual community benefit report Part I line 6a THE ANNUAL COMMUNITY BENEFIT AMOUNT RELATES TO THE VALUE OF SALARIES AND FRINGE BENEFITS OF THE HOSPITAL HEALTH SERVIVES DEPARTMENT WHICH PROVIDES SPECIALITY PHYSICIANS TO THE CARO COMMUNITY BY RENTING CLINIC SPACE AND PROVIDE RECEPTIONIST SERVICE TO THE PATIENTS OF TUSCOLA COUNTY AREA WHO WOULD HAVE TO DRIVE 35 TO 50 MILES OR EVEN TAKE THE DAY OFF FROM WORK TO RECEIVE ROUTINE SPECIALIST PHYSICIAN SERVICES 153185 ALSO THE COMMUNITY BENEFIT COST ASSOCIATED WITH PARTICIPATING IN BLOOD DRIVES DOING SPORTS PHYSICALSCOMMUNITY CRAFT PROGRAMS SENIOR FAIRS HEALTH EVENTS AT THE FAIRHOSPITAL AND AROUND THE CARO AREA IS 7288 TOTAL COOMUNITY BENEFIT VALUE IS 160473 03 Bad debt description footnote Part III line 4 MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED UPON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE 04 Subsidized health services costs Part I line 7g NA 05 Debt expense included Part I line 7 col f NA 06 Costing methodology explanation Part I line 7 07 Collection practices Part III line 9b IF THE PATIENT IS NOT ABLE TO MAKE PAYMENT ARRANGEMENTS THE STAFF WILL VERBALLY DETERMINE IF THE PATIENT IS POTENTIALLY ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL CHARITY CARE POLICY PATIENTS WHO APPEAR TO MEET THE CARO COMMUNITY HOSPITAL CRITERIA ARE REFERRED TO THE SOCIAL WORKER FOR FURTHER REVIEW IN ACCORDANCE WITH THE HOSPITAL CHARITY CARE POLICY 08 Needs assessment Part VI question 2 ORGANIZATION COMMUNICATED WITH STATE AND LOCAL AGENCIES TO DETERMINE THE HEALTHCARE NEEDS OF THE COMMUNITY EXAMPLES OF SERVICES PROVIDED BASED ON COMMUNITY NEEDS ARE IMMUNIZATIONS VACCINES SPORTS PHYSICALS SENIOR AND HEALTH FAIRS FIRST AID BOOTH AND DIABETIC CLASSES 09 Patient education Part VI question 3 EVERY UNINSURED PATIENT THAT IS AN INPATIENT OUTPATIENT SURGICAL OBSERVATION OR INCURS MORE THAN 5000 IN MEDICAL EXPENSES RECEIVES A CHARITY CARE PACKAGE THE PACKAGE INCLUDES A CHARITY CARE AND MEDICAID APPLICATION AND A HUMAN SERVICES REFERRAL FORM ALL OTHER NON-INSURED PATIENTS MAY REQUEST A CHARITY CARE APPLICATION AT ANY TIME 10 Community information Part VI question 4 ORGANIZATION IS LOCATED IN TUSCOLA COUNTY WHICH HAS A POPULATION OF APPROX 56000 CARO HAS A POPULATION OF APPROX 4200 TUSCOLA COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES THE UNEMPLOYMENT RATE IN TUSCLOA COUNTY IS HIGH BECAUSE OF THE LOSS OF MANY SMALL AUTOMOTIVE RELATED JOBS AND IS AT OR ABOVE THE STATE OF MICHIGANS UNEMPLOYMENT RATE 11 Promoting community health Part VI question 5 ORGAINZATION PROVIDES SPECIAL CLINICS IN CARO SO PATIENTS DO NOT HAVE TO COMMUTE 12 Affiliated health care system Part VI question 6 NA 13 State filings Part VI question 7 NA 14 Eligible patients billed Part V question 20 All patients are elgible for financial assistance of an extented payment plan depending on the dollar amount of the bill owed In 2012 emergent patients without any type of coverage were also extended a 20 discount plus offered an extended payment plan if needed The discount plan established in 2012 was based on the average total commercial coverage and one goverment plan which was workers compensation and the average came to 20 dicounted X X false false false false false false false false false WILLIAM P MILLER 154577 0 0 0 0 0 0 0 33205 0 187782 0 0 0 DR RICHARD MOYER 220135 0 0 0 0 0 0 0 40427 0 260562 0 0 0 DR JULIE SAWADE 180261 0 0 0 0 0 0 0 34193 0 214454 0 0 0 CCH ENDOWMENT FOUNDATION LOAN FOR DIGITAL MAM UNIT 136835 126569 false true true 126569 DALE PERZ - PERZPECTIVES BOARD MEMBER 60300 MARKETING SERVICES false 01. Form 990 governing body review (Part VI, line 11) EACH BOARD MEMBER WILL RECEIVE A COMPLETE COPY OF THE RETURN THE CEO AND CFO WILL REVIEW THE RETURN DURING THE NOVEMBER MEETING OF THE BOARD OF TRUSTEES 02. Conflict of interest policy compliance (Part VI, line 12c) THE CONFLICT OF INTEREST POLICY IS MONITORED THROUGH DISCUSSION WITH THE CEO AND EACH BOARD MEMBER 03. CEO, executive director, top management comp (Part VI, line 15a) THE BOARD UTILIZES THE MICHIGAN HEALTH AND HOSPITAL ANNUAL SURVEY TO DETERMINE THE COMPENSATION LEVEL FOR THE CEO 04. Governing documents, etc, available to public (Part VI, line 19) THE GOVERNING DOCUMENTS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC 05. Explanation of other changes in net assets or fund balances (Part XI, line 5) CCH FOUNDATION 60000 donation for digital mam NET CHANGE IN CCH ENDOWMENT FOUNDATION 9838 CCH HEALTH CARE ALLIANCE 401 N HOOPER ST CARO MI 487230435 383426058 PARENT TO CCH MI 501C3 III-F1 NA false CCH ENDOWMENT FOUNDATION 401 N HOOPER ST CARO MI 487230435 382422995 FOUNDATION MI 501C3 III-F1 NA false false false true false true false false false false false false false false false false false false false