COREWELL HEALTH: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-1297435)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-09
- IRS object ID
- 201221309349302027
- Schema version
- 2010v3.2
- 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 D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-09T16:00:40-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREWS HOOPER PAVLIK PLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3333 DEPOSIT DR NE STE 310 | AddressLine1 |
| City | GRAND RAPIDS | City |
| State | MI | State |
| ZIP Code | 49546 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381297435 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH KELSEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SPEC | NameControl |
| Phone | 6167544341 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S Bower | AddressLine1 |
| City | Greenville | City |
| State | MI | State |
| ZIP Code | 488382628 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RYAN K JOHNSON | Name |
| Title | INTERIM VP OF FINANCE | Title |
| Date Signed | 2012-04-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6169426440 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RYAN K JOHNSON | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S Bower | AddressLine1 |
| City | Greenville | City |
| State | MI | State |
| ZIP Code | 488382628 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14972580 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://UM.SPECTRUM-HEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1945 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 179 | TotalNbrEmployees |
| Total Nbr Volunteers | 4 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 78869 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 17812 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 13797609 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 14915959 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6760 | InvestmentIncomePriorYear |
| Investment Income Current Year | -25172 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 29272 | OtherRevenuePriorYear |
| Other Revenue Current Year | 38360 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 13912510 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14946959 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6355693 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7524985 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7250590 | OtherExpensePriorYear |
| Other Expenses Current Year | 7306262 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13606283 | TotalExpensesPriorYear |
| Total Expenses Current Year | 14831247 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 306227 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 115712 | RevenuesLessExpensesCY |
| Total Assets BOY | 3690353 | TotalAssetsBOY |
| Total Assets EOY | 4041984 | TotalAssetsEOY |
| Total Liabilities BOY | 926231 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1143182 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2764122 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2898802 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 12629464 | Expense |
| Revenue | 14900910 | Revenue |
| Description | SPECTRUM HEALTH KELSEY IS AN ACUTE CARE INPATIENT HOSPITAL, WHICH INCLUDES SPECIALTY CRITICAL CARE UNITS, OUTPATIENT SERVICES, AND LONG TERM SKILLED NURSING. THERE WERE 226 INPATIENT ADMISSIONS, 724 INPATIENT DAYS, 101 LONG-TERM CARE ADMISSIONS, 10,133 LONG-TERM CARE PATIENT DAYS, AND 7,881 EMERGENCY ROOM VISITS IN FISCAL YEAR 2011. | Description |
| Total Program Service Expense | 12629464 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 179 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ryan K Johnson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6162256310 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 S Bower | AddressLine1 |
| City | Greenville | City |
| State | MI | State |
| ZIP Code | 488382628 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| DOMENICO AUSIELLO MD | |||||||||
| DIRECTOR | 2 | X | 0 | 0 | 0 | ||||
| LINDA BLANCHARD | |||||||||
| SECRETARY | 2 | X | 0 | 0 | 0 | X | |||
| STEVE BOWSER | |||||||||
| DIRECTOR | 2 | X | 0 | 0 | 0 | ||||
| MARC CHIRCOP | |||||||||
| PART-YEAR DIRECTOR | 2 | X | 0 | 422621 | 178531 | ||||
| DAVID DULL MD | |||||||||
| DIRECTOR | 2 | X | 0 | 319332 | 135370 | ||||
| PETER HAINES | |||||||||
| DIRECTOR | 2 | X | 0 | 0 | 0 | ||||
| WILLIAM HAM | |||||||||
| TREASURER | 2 | X | 0 | 0 | 0 | X | |||
| DAVID MACK | |||||||||
| CHAIRMAN | 2 | X | 0 | 0 | 0 | X | |||
| FRANZ MOGDIS | |||||||||
| DIRECTOR | 2 | X | 0 | 0 | 0 | ||||
| GREGORY R PAGE MD PHD | |||||||||
| DIRECTOR | 2 | X | 0 | 204287 | 28629 | ||||
| TAD CHARLES SIMON | |||||||||
| DIRECTOR | 2 | X | 0 | 0 | 0 | ||||
| PAUL BONIS | |||||||||
| PRESIDENT | 2 | 0 | 281350 | 111869 | X | ||||
| DAVID OEHRING | |||||||||
| VP, FINANCE | 2 | 0 | 162930 | 29899 | X | ||||
| PRISCILLA MAHAR | |||||||||
| CHIEF CLINICAL OFFICER | 2 | 0 | 157445 | 16384 | X | ||||
| STEVEN FAHLEN | |||||||||
| PHYSICIAN | 50 | 257001 | 0 | 31290 | X | ||||
| MICHAEL BORGELD | |||||||||
| PHYSICIAN | 50 | 210724 | 0 | 27462 | X | ||||
| JAMES FARINOSI | |||||||||
| PHYSICIAN | 50 | 163575 | 0 | 12664 | X | ||||
| BRIAN BRASSER | |||||||||
| CHIEF NURSING/OPS | 2 | 0 | 159858 | 24699 | X | ||||
| MARY ANNE JONES | |||||||||
| FORMER CFO | 0 | 209945 | 31936 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 631300 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1917768 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 628733 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| INCREMEDICAL LLC | |||||
| 8259 WICKER AVE | ST JOHN | IN | 46373 | REHAB SERVICES | 274596 |
| TODD PRYOR DO | |||||
| 3615 WINDSHIRE DR SE | GRAND RAPIDS | MI | 49546 | PROFESSIONAL SERVICES | 260368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 17812 | AllOtherContributions |
| Noncash Contributions | 4972 | NoncashContributions |
| Total Contributions | 17812 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | 14835669 | 14835669 | |
| TRANSCRIPTION REVENUE | 561410 | 1729 | 1729 | |
| CAFETERIA | 722212 | 15498 | $15,498 | |
| OTHER HOSPITAL OPERATING INCOME | 900099 | 59377 | 59377 | |
| MEDICAL RECORD FEES | 900099 | 3686 | 3686 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 14915959 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 449 | TotalRevenueColumn |
| Related Or Exempt Function Income | 449 | RelatedOrExemptFunctionIncome |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 20053 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 20053 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20053 | TotalRevenueColumn |
| Exclusion | $20,053 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 25621 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | -25621 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -25621 | TotalRevenueColumn |
| Exclusion | -$25,621 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 18307 | TotalRevenueColumn |
| Exclusion | $18,307 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 18307 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14946959 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14900910 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $28,237 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5895712 | Total |
| Program Services | 5573035 | ProgramServices |
| Management And General | 322677 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211200 | Total |
| Program Services | 179825 | ProgramServices |
| Management And General | 31375 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1034710 | Total |
| Program Services | 881062 | ProgramServices |
| Management And General | 153648 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 383363 | Total |
| Program Services | 326411 | ProgramServices |
| Management And General | 56952 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39650 | Total |
| Program Services | 39650 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 904 | Total |
| Management And General | 904 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1273294 | Total |
| Program Services | 1256755 | ProgramServices |
| Management And General | 16539 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3308 | Total |
| Program Services | 802 | ProgramServices |
| Management And General | 2506 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1206018 | Total |
| Program Services | 1187722 | ProgramServices |
| Management And General | 18296 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145 | Total |
| Program Services | 145 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 626258 | Total |
| Program Services | 583881 | ProgramServices |
| Management And General | 42377 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22163 | Total |
| Program Services | 20530 | ProgramServices |
| Management And General | 1633 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 871 | Total |
| Program Services | 871 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239336 | Total |
| Program Services | 203781 | ProgramServices |
| Management And General | 35555 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131093 | Total |
| Program Services | 112305 | ProgramServices |
| Management And General | 18788 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| ADMINISTRATION ALLOCATION | 1516161 | 105861 | 1410300 |
| BAD DEBTS | 1256526 | 1256526 | |
| MCAID QUALITY ASSESSMENT TAX | 462978 | 462978 | |
| MISCELLANEOUS | 518305 | 428648 | 89657 |
| PROPERTY TAXES | 9252 | 8676 | 576 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14831247 | Total |
| Program Services | 12629464 | ProgramServices |
| Management And General | 2201783 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1000 | BOY |
| EOY | 1095 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9449 | BOY |
| EOY | 203 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1307103 | BOY |
| EOY | 954059 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69417 | BOY |
| EOY | 67291 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14545 | BOY |
| EOY | 11231 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7094232 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5194803 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2036215 | BOY |
| EOY | 1899429 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 252624 | BOY |
| EOY | 1108676 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3690353 | BOY |
| EOY | 4041984 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60672 | BOY |
| EOY | 59638 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 865559 | BOY |
| EOY | 1083544 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 926231 | BOY |
| EOY | 1143182 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2544449 | BOY |
| EOY | 2655189 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 219673 | BOY |
| EOY | 243613 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2764122 | BOY |
| EOY | 2898802 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3690353 | BOY |
| EOY | 4041984 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 115712 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 18968 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | 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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20157 | BeginningOfYearBalance |
| Contributions | 28250 | Contributions |
| Investment Earnings Or Losses | 3037 | InvestmentEarningsOrLosses |
| End Of Year Balance | 51444 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 11388 | BeginningOfYearBalance |
| Contributions | 8000 | Contributions |
| Investment Earnings Or Losses | 769 | InvestmentEarningsOrLosses |
| End Of Year Balance | 20157 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | 11388 | Contributions |
| End Of Year Balance | 11388 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 143310 | OtherCostOrOtherBasis |
| Book Value | 143310 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3904132 | OtherCostOrOtherBasis |
| Depreciation | 2763135 | Depreciation |
| Book Value | 1140997 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 155895 | OtherCostOrOtherBasis |
| Depreciation | 64743 | Depreciation |
| Book Value | 91152 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2837116 | OtherCostOrOtherBasis |
| Depreciation | 2324360 | Depreciation |
| Book Value | 512756 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 53779 | OtherCostOrOtherBasis |
| Depreciation | 42565 | Depreciation |
| Book Value | 11214 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1899429 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DONOR RESTRICTED ASSETS | 243613 |
| DUE FROM AFFILIATES | 865063 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1108676 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THIRD PARTY PAYABLE | Description |
| Amount | $1,083,544 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1083544 | TotalOfAmounts |
| Total Revenue | 14949634 | TotalRevenue |
| Total Expenses | 14827366 | TotalExpenses |
| Excess Or Deficit For Year | 122268 | ExcessOrDeficitForYear |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 122268 | ExcessOrDeficitPerFS |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 0 | RevenueSubtotal |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 0 | TotalRevenuePerForm990 |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 0 | ExpensesSubtotal |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 0 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Intended uses of endowment funds | Schedule D, Part V, Line 4 | THE FUNDS ARE CURRENTLY AN UNRESTRICTED, BOARD DESIGNATED ENDOWMENT AND HELD AS AN INVESTMENT. |
| FIN 48 FOOTNOTE | SCHEDULE D, PART X, LINE 2 | A FIN 48 FOOTNOTE WAS NOT INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 86513 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 86513 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00640 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3778716 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3013957 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 764759 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05630 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 3865229 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3013957 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 851272 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06270 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 3865229 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3013957 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 851272 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06270 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $616,931 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4496737 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4844904 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -348167 | 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 | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| 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 | SPECTRUM HEALTH KELSEY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 419 WASHINGTON AVE | AddressLine1 |
| City | LAKEVIEW | City |
| State | MI | State |
| ZIP Code | 48850 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | SPECTRUM HEALTH KELSEY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH REHAB AND NURSING CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 418 WASHINGTON AVE | AddressLine1 |
| City | LAKEVIEW | City |
| State | MI | State |
| ZIP Code | 48850 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | NURSING HOME | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Eligibility criteria for free or discounted care | Schedule H, Part I, Line 3c | THE ORGANIZATION USED FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. THERE WAS NOT AN EVALUATION USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFIED FOR ANY ASSISTANCE RECEIVED FREE CARE. |
| Bad Debt Expense excluded from financial assistance calculation | Schedule H, Part I, Line 7, column(f) | 1,256,526 |
| Costing Methodology used to calculate financial assistance | Schedule H, Part I, Line 7 | THE TAXPAYER CALCULATES AN OVERALL COST-TO-CHARGE RATIO DERIVED BY USING THE WORKSHEET 2 FORMAT, RATIO OF PATIENT CARE COST-TO-CHARGES. ALL PATIENT SEGMENTS AND PAYERS ARE USED IN THE CALCULATION. |
| Bad debt expense - financial statement footnote | Schedule H, Part III, Line 4 | CONSOLIDATED FINANCIAL STATEMENT FOOTNOTE EXTRACT RELATED TO UNCOLLECTIBLE ACCOUNTS: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER AMOUNTS DUE FROM THIRD-PARTY PAYORS ARE SATISFIED, AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES. COSTING METHODOLOGY USED IN DETERMINING THE FIGURES REPORTED IN SCHEDULE H, PART III, LINE 1: BAD DEBTS, AT COST, ARE DETERMINED BY USING AN OVERALL RATIO OF COST-TO-CHARGES APPLIED AGAINST BAD DEBT EXPENSE (AT CHARGES) IN THE STATEMENT OF ACTIVITIES. RATIONAL FOR INCLUDING BAD DEBTS (AT COST) IN SCHEDULE H, PART III, LINE 2: BAD DEBTS, AT COST, REPRESENT AN UNREIMBURSED LIABILITY TO THE TAXPAYER AND FURTHER DEMONSTRATE HOW, BY ASSUMING THOSE COSTS, THE TAXPAYER PROVIDES AND FULFILLS A HEALTH NEED IN THE COMMUNITY. IN ADDITION, EMERGENCY CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. SOME OF THESE SERVICES ARE PROVIDED TO INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE BUT, FOR PERSONAL OR OTHER PRIVATE REASONS, DON'T APPLY FOR FINANCIAL ASSISTANCE. USING THIS INFORMATIONAL TAX RETURN FOR ITS INTENDED PURPOSE, THE TAXPAYER CHOOSES TO BE FULLY TRANSPARENT AND SHARE ALL OF THE COSTS OF PROVIDING CHARITY CARE AND COMMUNITY BENEFITS TO THE COMMUNITIES WE SERVE, WHICH INCLUDES CHARITY CARE, THE COSTS OF FREE OR SUBSIDIZED COMMUNITY PROGRAMS, BAD DEBT EXPENSES REDUCED TO COST AND SHORTFALLS IN GOVERNMENT REIMBURSEMENTS (MEDICARE AND MEDICAID). RATIONAL FOR EXCLUDING (OR REPORTING ZERO) BAD DEBTS (AT COST) IN SCHEDULE H, PART III, LINE 3: THE TAXPAYER HAS NOT IDENTIFIED THE AMOUNT OF BAD DEBT EXPENSES (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH IT'S CERTAIN THAT A PORTION OF BAD DEBT EXPENSES (AT COST) RELATES TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE (HAD THEY PROVIDED INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE), A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. |
| Community benefit & methodology for determining medicare costs | Schedule H, Part III, Line 8 | THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS COULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. IN DETERMINING MEDICARE SHORTFALLS THE TAXPAYER USES A RATIO OF COST TO CHARGES. IN DETERMINING THE RATIO OF COST TO CHARGES THE TAXPAYER ADJUSTS FOR BAD DEBT EXPENSES, NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES AND COMMUNITY BENEFITS ACCOUNTED FOR AND OR REPORTED ELSEWHERE. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES TO DETERMINE SHORTFALLS IN MEDICARE REIMBURSEMENTS. |
| Collection practices for patients eligible for financial assistance | Schedule H, Part III, Line 9b | THE TAXPAYER COOPERATIVELY WORKS WITH PATIENTS HAVING SELF-PAY BALANCES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY. |
| Needs assessment. | Schedule H, Part VI, Line 2 | PERIODICALLY THE TAXPAYER CONDUCTS A COMMUNITY NEEDS ASSESSMENT USING RESULTS FROM LOCAL, STATE AND NATIONAL SOURCES. THE LAST SUCH COMMUNITY NEEDS ASSESSMENT UTILIZED THE FOLLOWING SOURCES: 1) AMERICA'S HEALTH RANKING: A CALL TO ACTION FOR PEOPLE AND THEIR COMMUNITIES. 2) AIMING HIGHER: RESULTS FROM A STATE SCORECARD ON HEALTH SYSTEM PERFORMANCE. 3) BEHAVIORAL RISK FACTOR SURVEY (2005): HEALTH RISK BEHAVIORS IN THE STATE OF MICHIGAN. 4) THE 2005/2006 COMMUNITY REPORT CARD. 5) THE 2005/2006 GREATER GRAND RAPIDS SURVEY. |
| Patient education of eligibility for assistance. | Schedule H, Part VI, Line 3 | TAXPAYER HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, THE TAXPAYER ALSO PROACTIVELY IDENTIFIES PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE AND PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF THE NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, PATIENT CONCERNS THAT ARE RECEIVED AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. IN ADDITION, THE TAXPAYER LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH "FINANCIAL ASSISTANCE" AT WWW.SPECTRUMHEALTH.ORG). TAXPAYER WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, VIA THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN EACH HOSPITAL DEPARTMENT, ADMISSIONS OFFICES AND OTHER PUBLIC LOCATIONS, POSTING ON THE SPECTRUM HEALTH WEBSITE, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. |
| Community information. | Schedule H, Part VI, Line 4 | THE TAXPAYER IS A CRITICAL ACCESS FACILITY THAT SERVES THE MEDICAL NEEDS OF THE RESIDENTS OF LAKEVIEW, MI AND THE FAR-NORTHERN PORTION OF A PRIMARY SERVICE AREA SHARED WITH UNITED MEMORIAL HOSPITAL, A RELATED ORGANIZATION. THE PRIMARY SERVICE AREA IS COMPRISED OF 19 ZIP CODES SURROUNDING LAKEVIEW, WHERE KELSEY HOSPITAL IS LOCATED, AND INCLUDES MONTCALM AND PORTIONS OF ADJACENT COUNTIES THAT SUPPORTS A POPULATION OF OVER 100,000 RESIDENTS. |
| Promotion of community health | Schedule H, Part VI, Line 5 | SCHEDULE H OF THIS TAX RETURN ONLY DISCLOSES CHARITY CARE AND COMMUNITY BENEFIT INFORMATION PERTAINING TO THE REPORTING ENTITY. HOWEVER, FOR A FULL AND MORE ACCURATE UNDERSTANDING OF THE CHARITY CARE AND COMMUNITY BENEFITS PROVIDED BY THE CONSOLIDATED HEALTH SYSTEM PLEASE VISIT OUR WEBSITE AT WWW.SPECTRUMHEALTH.ORG AND CLICK THE LINK TITLED "ABOUT US". |
| RELATED ORGANIZATION INFORMATION | SCHEDULE H, PART I, LINE 6A | THE CONSOLIDATED HEALTH SYSTEM PUBLISHES THEIR COMMUNITY BENEFIT REPORT ON THEIR WEBSITE AT WWW.SPECTRUMHEALTH.ORG (CLICK THE LINK TITLED "ABOUT US"). IN ADDITION, THE HEALTH SYSTEM HOLDS AN ANNUAL MEETING TO THE PUBLIC TO DISCUSS ITS COMMUNITY COMMITMENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARC CHIRCOP | |||||||||||||
| 0 | 362934 | 0 | 45480 | 0 | 14207 | 0 | 124900 | 0 | 53631 | 0 | 601152 | 0 | 0 |
| DAVID DULL MD | |||||||||||||
| 0 | 271628 | 0 | 45993 | 0 | 1711 | 0 | 87712 | 0 | 47658 | 0 | 454702 | 0 | 0 |
| GREGORY R PAGE MD PHD | |||||||||||||
| 0 | 179517 | 0 | 24504 | 0 | 266 | 0 | 13924 | 0 | 14705 | 0 | 232916 | 0 | 0 |
| PAUL BONIS | |||||||||||||
| 0 | 229997 | 0 | 49556 | 0 | 1797 | 0 | 66661 | 0 | 45208 | 0 | 393219 | 0 | 0 |
| DAVID OEHRING | |||||||||||||
| 0 | 136243 | 0 | 23903 | 0 | 2784 | 0 | 10280 | 0 | 19619 | 0 | 192829 | 0 | 0 |
| PRISCILLA MAHAR | |||||||||||||
| 0 | 132257 | 0 | 22306 | 0 | 2882 | 0 | 5479 | 0 | 10905 | 0 | 173829 | 0 | 0 |
| STEVEN FAHLEN | |||||||||||||
| 253388 | 0 | 2650 | 0 | 963 | 0 | 9800 | 0 | 21490 | 0 | 288291 | 0 | 0 | 0 |
| MICHAEL BORGELD | |||||||||||||
| 209742 | 0 | 0 | 0 | 982 | 0 | 7346 | 0 | 20116 | 0 | 238186 | 0 | 0 | 0 |
| JAMES FARINOSI | |||||||||||||
| 157880 | 0 | 0 | 0 | 5695 | 0 | 3249 | 0 | 9415 | 0 | 176239 | 0 | 0 | 0 |
| BRIAN BRASSER | |||||||||||||
| 0 | 134667 | 0 | 22350 | 0 | 2841 | 0 | 5720 | 0 | 18979 | 0 | 184557 | 0 | 0 |
| MARY ANNE JONES | |||||||||||||
| 0 | 175034 | 0 | 27431 | 0 | 7480 | 0 | 13524 | 0 | 18412 | 0 | 241881 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental nonqualified retirement plan | Identifier |
| Return Reference | Schedule J, Part I, Line 4b | ReturnReference |
| Explanation | SCHEDULE J, PART I, LINE 4B IS ANSWERED "YES" BECAUSE CERTAIN INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE PAID BY THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION, DO "PARTICIPATE IN" A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. HOWEVER, NONE OF THESE PARTICIPANTS "RECEIVED PAYMENT FROM" THESE PLANS DURING THE TAX YEAR. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| ANESTHESIA MEDICAL CONSULTANTS | |||
| BUSINESS | 1201250 | SEE SCHEDULE L, PART V | false |
| WEST MICHIGAN SHARED LAUNDRY | |||
| BUSINESS | 50374 | SEE SCHEDULE L, PART V | |
| HATHAWAY PROPERTIES LLC | |||
| BUSINESS | 420000 | SEE SCHEDULE L, PART V | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS RELATIONSHIPS AND TRANSACTIONS WITH INTERESTED PERSONS | Identifier |
| Return Reference | PART IV, LINE 28C & SCH L, PART IV | ReturnReference |
| Explanation | DR. DAVID DULL, A MEMBER OF THE TAXPAYER'S BOARD OF DIRECTORS, IS A DIRECTOR OF A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE TAXPAYER. MR. WILLIAM HAM, A MEMBER OF THE TAXPAYER'S BOARD OF DIRECTORS, HAS OWNERSHIP IN A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE TAXPAYER. MS. PRISCILLA MAHAR, A KEY EMPLOYEE OF THE TAXPAYER, IS A DIRECTOR OF A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH THE TAXPAYER. THROUGH THE ANNUAL CONFLICT OF INTEREST AND TAX REPORTING PROCESSES, CERTAIN INDIVIDUALS LISTED IN SCH L HAVE REPORTED THAT THEY, OR COMPANIES THEY WORK FOR, HAVE BUSINES OR FAMILY RELATIONSHIPS WITH THE REPORTING ORGANIZATION THAT EXCEED THRESHHOLDS PROVIDED IN THE INSTRUCTIONS TO THE FORM 990. IF AN AMOUNT IS NOT LISTED IN SCH L, A STATEMENT IS PROVIDED ABOVE EXPLAINING THE NATURE OF THE TRANSACTION(S). | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NUMBER OF EMPLOYEES | FORM 990, PART I, LINE 5 AND FORM 990, PART V, LINE 2A | TAXPAYER MAY HAVE INDIRECT EMPLOYEES. COMPENSATION FOR THESE EMPLOYEES IS PAID BY A RELATED ORGANIZATION. AN ALLOCATION OF AMOUNTS PAID FOR INDIRECT EMPLOYEES IS PURSUANT TO A MANAGEMENT SERVICES CONTRACT AND IS INCLUDED ON LINES 5-10 OF PART IX. |
| IDENTIFICATION OF DISREGARDED ENTITIES | FORM 990, PART IV, LINE 33 AND SCHEDULE R | THE ORGANIZATION DOES NOT OWN A WHOLLY OWNED DISREGARDED ENTITY. HOWEVER, THE HEALTH SYSTEM HAS WHOLLY OWNED DISREGARDED ENTITIES. THE ORGANIZATION IS REPORTING INDIRECT CONTROL FOLLOWING THE CONSTRUCTIVE OWNERSHIP RULES UNDER SECTION 318 OF THE INTERNAL REVENUE CODE. OTHER ENTITIES REPORTED ON SCHEDULE R ARE REPORTED BASED ON THE SAME APPLICATION OF THE CONSTRUCTIVE OWNERSHIP RULES OF SECTION 318. |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | THE TAXPAYER HAS ONE MEMBER(S)/STOCKHOLDER(S) AS FOLLOWS: - SPECTRUM HEALTH UNITED (F/K/A UNITED MEMORIAL HOSPITAL ASSOCIATION) (EIN 38-1358412), A MICHIGAN NONPROFIT CORPORATION. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | THE SOLE MEMBER(S) (SEE FORM 990, PART VI, LINE 6) OF THE TAXPAYER APPOINTS ALL MEMBERS OF THE BOARD OF DIRECTORS. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | UNLESS OTHERWISE NOTED BELOW, THE SOLE MEMBER(S) (SEE FORM 990, PART VI, LINE 6) OF THE TAXPAYER HAS THE RESERVED POWERS SET FORTH BELOW, AND SHALL NOT BE DEEMED AUTHORIZED UNLESS AND UNTIL APPROVED BY THE SOLE MEMBER(S): -THE ADOPTION OF OR AMENDMENTS TO THE ARTICLES OF INCORPORATION AND/OR THE BYLAWS OF THE TAXPAYER (THE "GOVERNING DOCUMENTS") OR ANY SUBSIDIARY OF THE TAXPAYER; -THE ADOPTION OF OR AMENDMENT OF STRATEGIC PLANS, VISIONS, BUSINESS PLANS, JOINT VENTURES AND FACILITY MASTER PLANS; -THE ADOPTION OF OR AMENDMENT OF THE ANNUAL OPERATING AND CAPITAL BUDGETS; -APPROVAL OF CAPITAL EXPENDITURES PURSUANT TO GUIDELINES AS ADOPTED AND/OR REVISED BY UNITED FROM TIME TO TIME; -APPROVAL OF ALL BORROWING FOR CAPITAL OR OPERATING PURPOSES, ALL GUARANTEES OF INDEBTEDNESS, AND ALL MORTGAGES OF REAL ESTATE; -APPROVAL OF ALL PROJECTS REQUIRING A CERTIFICATE OF NEED UNDER MICHIGAN LAW; -APPROVAL OF THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF PROPERTY PURSUANT TO GUIDELINES AS ADOPTED AND/OR REVISED BY UNITED FROM TIME TO TIME; -APPROVAL OF THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE TAXPAYER, OR THE DIVESTITURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR CHANGE IN CORPORATE MEMBERSHIP OF THE TAXPAYER OR ANY SUBSIDIARY OF THE TAXPAYER; OR -ANY OTHER APPROVAL OF UNITED REQUIRED BY LAW OR BY THE GOVERNING DOCUMENTS. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11a | A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE REVIEW PROCESS FOR THIS FORM 990 IS AS FOLLOWS: 1. PREPARATION OF THE RETURN IS SUPERVISED AND REVIEWED BY THE TAXPAYER'S CORPORATE TAX MANAGER. 2. A SECOND REVIEW IS PERFORMED BY AN EXTERNAL CPA FIRM WITH EXPERTISE IN TAX-EXEMPT RETURN PREPARATION. 3. THE RETURN IS REVIEWED BY THE TAXPAYER'S FINANCE AND LEGAL DEPARTMENTS (INCLUDING THE VICE PRESIDENT OF FINANCE OR CHIEF FINANCIAL OFFICER) AND SHARED WITH THE MEMBERS OF THE BOARD OF DIRECTORS. 4. THE TAXPAYER'S VICE PRESIDENT OF FINANCE OR CHIEF FINANCIAL OFFICER REVIEWS COMMENTS OR QUESTIONS RECEIVED BY MEMBERS OF THE BOARD OF DIRECTORS, IF ANY, TO ADDRESS OR TO INCORPORATE, AS APPROPRIATE, INTO THE RETURN PRIOR TO FILING. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | BOARD OF DIRECTORS 1.CONFLICTS OF INTEREST MUST BE DISCLOSED, BOTH VIA A DISCLOSURE FORM PROCESS AS WELL AS VERBALLY AT A BOARD MEETING PRIOR TO DISCUSSION OF ANY AGENDA ITEM WITH REGARD TO WHICH A BOARD MEMBER HAS A CONFLICT. 2.A PERSON HAVING A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT MAY MAKE A PRESENTATION AT A MEETING OF THE BOARD OF DIRECTORS OR COMMITTEE CONSIDERING THAT TRANSACTION OR ARRANGEMENT, BUT AFTER THAT PRESENTATION HE OR SHE SHALL LEAVE THE MEETING DURING DISCUSSION AND VOTING ON THAT PROPOSED TRANSACTION OR ARRANGEMENT. THE PERSON HAVING THE FINANCIAL INTEREST SHALL NOT BE COUNTED IN DETERMINING WHETHER A QUORUM IS PRESENT. 3.THE CHAIRPERSON OF THE BOARD OF DIRECTORS OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE (INCLUDING OUTSIDE ADVISORS) TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND TO ADVISE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN SPECTRUM HEALTH'S BEST INTEREST. 4.THE BOARD OF DIRECTORS OR COMMITTEE SHALL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER SPECTRUM HEALTH CAN, WITH REASONABLE EFFORTS, OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 5.IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OF DIRECTORS OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS AND MEMBERS WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN SPECTRUM HEALTH'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO SPECTRUM HEALTH, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 6.THE MINUTES OF THE MEETINGS OF THE BOARD OF DIRECTORS AND ALL SPECTRUM HEALTH COMMITTEES SHALL SET FORTH: A)THE NAMES OF THE PERSONS WHO DISCLOSED A FINANCIAL INTEREST IN A PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING SPECTRUM HEALTH OR ANY OF ITS SUBSIDIARIES AND THE NATURE OF THE FINANCIAL INTEREST; AND B)THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO SUCH TRANSACTION OR ARRANGEMENT, INCLUDING ANY DISCUSSION OF ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THAT MATTER. THE VOTES OF INDIVIDUAL MEMBERS NEED NOT BE RECORDED UNLESS OTHERWISE DIRECTED BY THE BOARD OF DIRECTORS OR COMMITTEE. MANAGEMENT 1. UPON ACCEPTANCE OF AN EMPLOYMENT OFFER, EACH MEMBER OF MANAGEMENT WILL COMPLETE A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE. A COPY OF THE MEMBER OF MANAGEMENT'S DISCLOSURE QUESTIONNAIRE IS SENT TO THE TAXPAYER'S LEGAL DEPARTMENT AND IS ALSO MAINTAINED BY HUMAN RESOURCES IN THAT PERSON'S PERSONNEL FILE. 2. ANNUALLY, EACH MEMBER OF MANAGEMENT WILL COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE ELECTRONICALLY. THE DISCLOSURE QUESTIONNAIRE IS REVIEWED BY THE LEGAL AND ORGANIZATIONAL INTEGRITY DEPARTMENTS. 3. THERE IS AN ONGOING REQUIREMENT THAT MEMBERS OF MANAGEMENT COMPLETE ANOTHER DISCLOSURE QUESTIONNAIRE AT ANY POINT DURING HIS/HER EMPLOYMENT WHEN A NEW POTENTIAL CONFLICT OF INTEREST ARISES. IF A MEMBER OF MANAGEMENT COMPLETES A DISCLOSURE QUESTIONNAIRE AS A RESULT OF A NEW POTENTIAL CONFLICT OF INTEREST, THAT DISCLOSURE QUESTIONNAIRE IS SUBMITTED TO THE LEGAL AND ORGANIZATIONAL INTEGRITY DEPARTMENTS FOR REVIEW. 4. THE LEGAL AND ORGANIZATIONAL INTEGRITY DEPARTMENTS, IN CONSULTATION WITH EXECUTIVE MANAGEMENT, DETERMINE HOW ANY REPORTED CONFLICTS SHOULD BE MANAGED. MANAGEMENT OF A CONFLICT MAY TAKE A VARIETY OF DIFFERENT FORMS FROM IMPLEMENTATION OF A MANAGEMENT PLAN TO REQUIRING THAT THE MEMBER OF MANAGEMENT CEASE THE ACTIVITY CREATING THE CONFLICT OR, IN EXTREME CASES, LEAVE TAXPAYER'S EMPLOYMENT. MANAGEMENT IS DETERMINED ON AN INDIVIDUAL BASIS BASED UPON THE FACTS AND CIRCUMSTANCES SURROUNDING THE DISCLOSURE. THE PURPOSE OF CONFLICT MANAGEMENT IS TO PROVIDE TRANSPARENCY WITHIN THE TAXPAYER AND TO ENSURE THAT TAXPAYER'S EMPLOYEES ARE ALWAYS ACTING IN THE BEST INTEREST OF TAXPAYER. |
| Process used to establish compensation of top management official | Form 990, Part VI, Section B, Line 15a | SPECTRUM HEALTH SYSTEM PROCESS FOR ESTABLISHING EXECUTIVE COMPENSATION THE SPECTRUM HEALTH BOARD OF DIRECTORS (EXECUTIVE COMMITTEE) USES THE FOLLOWING PROCESS FOR DETERMINING COMPENSATION OF EXECUTIVES AT ALL ENTITIES: *LABOR MARKET DATA REFLECTING COMPARABLE ORGANIZATIONS AND JOBS (PREPARED BY INDEPENDENT FIRMS) ARE RELIED UPON. *COMPETITIVE ASSESSMENT REPORTS ARE PROVIDED IN ADVANCE OF EXECUTIVE COMMITTEE MEETINGS. THE COMPETITIVE ASSESSMENT REPORT IS PREPARED BY A NATIONALLY KNOWN INDEPENDENT EXECUTIVE COMPENSATION FIRM AND, FOR FY 2011 (7/1/10-6/30/11), WAS BASED ON THE FOLLOWING INDEPENDENT SURVEYS OF HEALTH CARE EXECUTIVES AT COMPARABLE HEALTH SYSTEMS: * SULLIVAN, COTTER AND ASSOCIATES, INC.: 2010 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS * INTEGRATED HEALTHCARE STRATEGIES: 2010 HEALTHCARE EXECUTIVE COMPENSATION SURVEY * MERCER HUMAN RESOURCES CONSULTING: 2010 INTEGRATED HEALTH NETWORKS COMPENSATION SURVEY * WATSON WYATT DATA SERVICES: 2010/2011 HOSPITAL AND HEALTHCARE MANAGEMENT COMPENSATION REPORT *THESE SOURCES ARE CONSISTENT WITH THOSE USED IN LAST YEAR'S ANALYSIS. *COMPENSATION ADJUSTMENTS ARE APPROVED BY INDEPENDENT EXECUTIVE COMMITTEE MEMBERS, CONSISTENT WITH THE SPECTRUM HEALTH COMPENSATION PHILOSOPHY DESCRIBED BELOW. *MINUTES OF COMMITTEE DISCUSSIONS AND DECISIONS ARE PREPARED TO MEMORIALIZE EXECUTIVE COMMITTEE DECISIONS BASED UPON THE ABOVE DATA. CASH COMPENSATION DATA RELIED UPON BY THE EXECUTIVE COMMITTEE ARE NATIONAL AND REFLECT THE COMPENSATION PAID TO EXECUTIVES IN COMPARABLE JOBS IN COMPARABLY-SIZED HEALTHCARE ORGANIZATIONS. SPECTRUM HEALTH RECRUITS NATIONALLY FOR ITS EXECUTIVES. BENEFITS DATA REFLECT NATIONAL HEALTHCARE MARKET PRACTICES. GEOGRAPHIC PAY DIFFERENTIAL AND COST OF LIVING DATA INDICATE CONSISTENCY WITH NATIONAL DATA. THIS PROCESS IS INTENDED TO ASSIST SPECTRUM HEALTH IN QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS (INTERMEDIATE SANCTIONS REGULATIONS) AND THE SPECTRUM HEALTH EXCESS BENEFIT TRANSACTION POLICY FOR THOSE INDIVIDUALS IN THE GROUP WHO ARE DISQUALIFIED PERSONS*. THE OPINION SUBMITTED FROM THE THIRD PARTY INDEPENDENT CONSULTING FIRM IS IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATIONS SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENT OF TREASURY REGULATIONS SECTION 53.4958-1(D)(4)(III). |
| Process used to establish compensation of other officers/key employees | Form 990, Part VI, Section B, Line 15b | SEE EXPLANATION PROVIDED FOR FORM 990, PART VI, LINE 15A. |
| Public Disclosure | Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION HAVE BEEN PROVIDED TO THE STATE OF MICHIGAN AND ARE AVAILABLE TO THE PUBLIC ON THE STATE'S WEBSITE. THE ORGANIZATION'S BYLAWS AND INTERNAL POLICIES ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. THE OVERALL SYSTEM CONSOLIDATED FINANCIAL STATEMENTS ARE PROVIDED AT WWW.SPECTRUMHEALTH.ORG IN THE SECTION TITLED "ABOUT US." FINANCIAL PERFORMANCE IS DISCUSSED AT AN ANNUAL PUBLIC MEETING HELD AND POSTED TO WWW.SPECTRUMHEALTH.ORG ANNUALLY (UNDER THE SECTION TITLED "ABOUT US"). |
| Average hours worked per week for related organization | Form 990, Part VII, Section A, Column B | DOMENICO AUSIELLO, MD - 0 LINDA BLANCHARD - 0 STEVE BOWSER - 0 MARC CHIRCOP - 50 DAVID DULL, MD - 50 PETER HAINES - 0 WILLIAM HAM - 0 DAVID MACK - 0 FRANZ MOGDIS - 0 GREGORY R PAGE, M.D., PH.D. - 50 TAD (CHARLES) SIMON - 0 PAUL BONIS - 50 DAVID OEHRING - 50 PRISCILLA MAHAR - 50 STEVEN FAHLEN - 0 MICHAEL BORGELD - 0 JAMES FARINOSI - 0 BRIAN BRASSER - 50 MARY ANNE JONES - 50 |
| COMPENSATION | FORM 990, PART VII, LINE 1A | CONSISTENT WITH PRIOR YEARS, THE COMPENSATION REPORTED FOR THESE INDIVIDUALS IS NOT FOR SERVICES IN THEIR CAPACITY AS MEMBERS OF THE BOARD OF DIRECTORS BUT FOR SERVICES AS EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION. CONSISTENT WITH PRIOR YEARS, COMPENSATION AND BENEFITS ARE REPORTED USING THE MOST RECENT CALENDAR YEAR COMPENSATION DATA. THE COMPENSATION FIGURES REPORTED IN THESE SECTIONS IS FOR THE YEAR ENDED DECEMBER 31, 2010. INDIVIDUALS WITH COMPENSATION REPORTED IN PART VII WORK A COMBINED AVERAGE OF 50 HOURS PER WEEK FOR THE REPORTING ORGANIZATION AND/OR A RELATED TAX-EXEMPT ORGANIZATION. |
| Other changes in net assets or fund balances | Form 990, Part XI, Line 5 | FAS 136 ACTIVITY - 23940; NON CASH CONTRIBUTIONS - -4972; |
| OVERSIGHT OF THE AUDIT | FORM 990, PART XII, LINE 2C | THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION WERE AUDITED BY AN INDEPENDENT AUDITOR AS PART OF THE CONSOLIDATED AUDIT OF SPECTRUM HEALTH SYSTEM (EIN 38-3382353). THE OVERSIGHT OF THAT AUDIT IS BEING ASSUMED BY SPECTRUM HEALTH SYSTEM. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| PHMB PROPERTIES LLC | |||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382715520 | PROP. MGMT | MI | 179821 | 29996933 | PRIORITY HEALTH |
| MMPC REAL ESTATE LLC | |||||||||
| 4100 LAKE DR SE STE 300 | GRAND RAPIDS | MI | 49525 | 382851295 | DORMANT | MI | 0 | 0 | MICHIGAN MEDICAL PATIENT CARE |
| SPECTRUM HEALTH INNOVATIONS LLC | |||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 272868213 | IP DEVELOP | MI | 6018 | 3146005 | SPECTRUM HEALTH SYSTEM |
Form990 Schedule R Part II Form990ScheduleRPartII (24 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| SPECTRUM HEALTH SYSTEM | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 383382353 | MANAGEMENT | MI | 501(C)(3) | 10 - Type III - FI | NA | false |
| SPECTRUM HEALTH HOSPITALS | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 381360529 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | true |
| SPECTRUM HEALTH PRIMARY CARE PTNRS | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 381358164 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | true |
| WEST MICHIGAN REGIONAL LABORATORY | ||||||||||
| 1726 KNOLLCREST CIRCLE SE | GRAND RAPIDS | MI | 49546 | 383414862 | TEACH/RSCH | MI | 501(C)(3) | 9 | SPECTRUM HEALTH HOSPITALS | true |
| SPECTRUM HEALTH FOUNDATION | ||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | 382752328 | PHILANTHRO | MI | 501(C)(3) | 7 | SPECTRUM HEALTH SYSTEM | true |
| SPECTRUM HEALTH CONTINUING CARE | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 383242232 | REHAB/CARE | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH SYSTEM | true |
| SH CONTINUING CARE CENTER | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 382415333 | REHAB/NRS | MI | 501(C)(3) | 9 | SPECTRUM HEALTH CONTINUING CARE | true |
| SH KENT COMMUNITY CAMPUS | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 383472677 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH CONTINUING CARE | true |
| SPECTRUM HEALTH WORTH SERVICES | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 382786617 | HEALTHCARE | MI | 501(C)(3) | 9 | SPECTRUM HEALTH CONTINUING CARE | true |
| VISITING NURSE SERVICES OF WEST MI | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 381359195 | HEALTHCARE | MI | 501(C)(3) | 9 | SPECTRUM HEALTH CONTINUING CARE | true |
| PRIORITY HEALTH | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382715520 | HMO | MI | 501(C)(4) | N/A | SPECTRUM HEALTH SYSTEM | true |
| TRINITY HEALTH PLANS | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 382663747 | HMO MGMT | MI | 501(C)(4) | N/A | PRIORITY HEALTH | true |
| PH GOVERNMENT PROGRAMS INC | ||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 320016523 | HMO | MI | 501(C)(3) | 9 | PRIORITY HEALTH | true |
| SPECTRUM HEALTH UNITED | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 381358412 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | true |
| SH UNITED MEMORIAL FOUNDATION | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 382990574 | PHILANTHRO | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH UNITED | true |
| AMBULATORY UNITED | ||||||||||
| 407 S NELSON | GREENVILLE | MI | 48838 | 383170488 | HEALTHCARE | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH UNITED | true |
| UNITED LIFESTYLES | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 383589727 | WELLNESS | MI | 501(C)(3) | 11 - Type I | SPECTRUM HEALTH UNITED | true |
| SPECTRUM HEALTH KELSEY | ||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 381297435 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH UNITED | true |
| REED CITY HOSPITAL CORPORATION | ||||||||||
| 300 N PATTERSON RD | REED CITY | MI | 49677 | 382770076 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | true |
| WEST MICHIGAN IMAGING CENTER | ||||||||||
| PO BOX 1009 | JENISON | MI | 49428 | 382730326 | HEALTHCARE | MI | 501(C)(3) | 9 | SPECTRUM HEALTH HOSPITALS | true |
| NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION | ||||||||||
| 212 S SULLIVAN AVENUE | FREMONT | MI | 49412 | 381359517 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | true |
| MMPC FOUNDATION | ||||||||||
| 4100 LAKE DR SE STE 300 | GRAND RAPIDS | MI | 49546 | 201099059 | PHILANTHRO | MI | 501(C)(3) | N/A | MICHIGAN MEDICAL PATIENT CARE | true |
| KENT COMMUNITY HEALTH FOUNDATION | ||||||||||
| 750 FULLER AVE NE | GRAND RAPIDS | MI | 49503 | 383607110 | PHILANTHRO | MI | 501(C)(3) | 11 - Type III - FI | SPECTRUM HEALTH KENT COMMUNITY CAMPUS | true |
| ZEELAND COMMUNITY HOSPITAL | ||||||||||
| 100 SOUTH PINE | ZEELAND | MI | 49464 | 381411184 | HEALTHCARE | MI | 501(C)(3) | 3 | SPECTRUM HEALTH SYSTEM | true |
Form990 Schedule R Part IV Form990ScheduleRPartIV (12 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 | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HELEN DEVOS WOMEN'S AND CHILDREN'S HEALTH PAVILION ASSOCIATION | ||||||||||||
| 1840 WEALTHY ST SE | GRAND RAPIDS | MI | 49506 | 383264184 | MGMT | MI | SPECTRUM HEALH HOSPITALS | C CORPORATION | 611739 | 462237 | 0.8696 | |
| PARTNERSHIP FOR CHILDREN'S HEALTH | ||||||||||||
| 1840 WEALTHY ST SE | GRAND RAPIDS | MI | 49506 | 383364676 | MGED CARE | MI | SPECTRUM HEALH HOSPITALS | C CORPORATION | 0 | 0 | 1 | |
| THE FRED AND LENA MEIJER HEART CENTER CONDOMINIUM ASSOCIATION | ||||||||||||
| 100 MICHIGAN ST NE | GRAND RAPIDS | MI | 49503 | 830464302 | MGMT | MI | SPECTRUM HEALH HOSPITALS | C CORPORATION | 2205785 | 1454395 | 0.9827 | |
| HDVCH - CHC | ||||||||||||
| 100 MICHIGAN ST NE | GRAND RAPIDS | MI | 49503 | 383417270 | MED. SVCS | MI | SPECTRUM HEALH HOSPITALS | C CORPORATION | 1800 | 0 | 1 | |
| CAMPUS TOWNE CENTER CONDO ASSC | ||||||||||||
| 4868 LAKE MICHIGAN DRIVE | ALLENDALE | MI | 49401 | 382910067 | MGMT | MI | SPECTRUM HEALH HOSPITALS | C CORPORATION | 20826 | 24780 | 0.75 | |
| PRIORITY HEALTH INSURANCE COMPANY | ||||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 201529553 | INSURANCE | MI | PRIORITY HEALTH | C CORPORATION | 217156804 | 65878919 | 1 | |
| PRIORITY HEALTH MANAGED BENEFITS | ||||||||||||
| 1231 EAST BELTLINE NE | GRAND RAPIDS | MI | 49525 | 383085182 | ADMIN | MI | SPECTRUM HEALTH SYSTEM | C CORPORATION | 129683594 | 29767226 | 1 | |
| MONTCALM PRIMARY CARE PHYSICIANS | ||||||||||||
| 615 S BOWER | GREENVILLE | MI | 48838 | 202544762 | MED. SVCS | MI | SPECTRUM HEALTH UNITED | C CORPORATION | 0 | 0 | 1 | |
| BLODGETT ASSURANCE COMPANY | ||||||||||||
| 100 MICHIGAN AVE NE | GRAND RAPIDS | MI | 49503 | INSURANCE | SPECTRUM HEALTH SYSTEM | C CORPORATION | 0 | 0 | 1 | CJ | ||
| MICHIGAN MEDICAL PATIENT CARE | ||||||||||||
| 4100 LAKE DR SE STE 300 | GRAND RAPIDS | MI | 49546 | 382851295 | MEDICAL | MI | SPECTRUM HEALTH SYSTEM | C CORPORATION | 0 | 0 | 1 | |
| WEST MICHIGAN HEART | ||||||||||||
| 2900 BRADFORD STREET NE | GRAND RAPIDS | MI | 49525 | 382125186 | PHYSICIANS | MI | SPECTRUM HEALTH SYSTEM | C CORPORATION | 0 | 0 | 1 | |
| MHEALTH INNOVATIONS INC | ||||||||||||
| 425 NORTH MAIN STREET | ANN ARBOR | MI | 48104 | 611613614 | PROD DEVL | MI | SPECTRUM HEALTH INNOVATIONS LLC | C CORPORATION | 0 | 457129 | 1 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PRIORITY HEALTH | ||
| K | 1332594 | GAAP, CASH, OR FMV |
| SPECTRUM HEALTH UNITED MEMORIAL FOUNDATION | ||
| C | 17812 | GAAP, CASH, OR FMV |
| SPECTRUM HEALTH CONTINUING CARE | ||
| K | 51454 | GAAP, CASH, OR FMV |
| SPECTRUM HEALTH SYSTEM | ||
| L | 83790 | GAAP, CASH, OR FMV |
| SPECTRUM HEALTH HOSPITALS | ||
| L | 706866 | GAAP, CASH, OR FMV |
| PRIORITY HEALTH | ||
| L | 937453 | GAAP, CASH, OR FMV |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART II, COLUMN (G), SECTION 512(B)(13) CONTROLLED ENTITY? | Identifier |
| Return Reference | SCHEDULE R | ReturnReference |
| Explanation | TAXPAYER IS A MEMBER OF A CONSOLIDATED HEALTH SYSTEM AND HAS A COMMON PARENT ORGANIZATION, SPECTRUM HEALTH SYSTEM. FOR ENTITIES THAT ARE PART OF A CONSOLIDATED HEALTH SYSTEM (WITH COMMON CONTROL) THE ATTRIBUTION RULES OF IRC SECTION 318 APPLY; MEANING THAT ALL ORGANIZATIONS ARE DEEMED TO HAVE CONTROL OF THE ORGANIZATIONS OWNED BY THE CONTROLLING ORGANIZATION. AS SUCH, IN ANSWERING THIS QUESTION AND FOR REPORTING IN SCH. R, EACH RELATED ORGANIZATION WITHIN THE HEALTH SYSTEM IS CONSIDERED AND THE TRANSACTIONS DISCLOSED MAY BE BETWEEN DIRECTLY CONTROLLED SUBSIDIARIES OR BROTHER-SISTER ENTITIES (INDIRECTLY CONTROLLED) WITHIN THE HEALTH SYSTEM. | Explanation |
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