HENRY FORD HEALTH ROCHESTER HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HENRY FORD HEALTH ROCHESTER HOSPITAL (EIN 38-1359247)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201223209349305317
Schema version
2011v1.2
Note
A later return for the same period supersedes this one.
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-15T13:31:03-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 307AddressLine1
CitySOUTHFIELDCity
StateMIState
ZIP Code480370307ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381359247EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CRITTENTON HOSPITAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCRITNameControl
Phone2486525000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 W UNIVERSITY DRIVEAddressLine1
CityROCHESTERCity
StateMIState
ZIP Code48307ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANK SOTTILE MDName
TitleINTERIM CEOTitle
Phone2486525000Phone
Date Signed2012-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSUE MIENCIERName
PTINP00842339PTIN
Phone2483522500Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonFRANK SOTTILE MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11101 W UNIVERSITY DRIVEAddressLine1
CityROCHESTERCity
StateMIState
ZIP Code48307ZIPCode
FieldValueIRS element (for citing)
Gross Receipts336449120GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CRITTENTON.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1900YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionENHANCING THE HEALTH STATUS OF THE INDIVIDUALS AND COMMUNITIES IT SERVES.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees1888TotalNbrEmployees
Total Nbr Volunteers366TotalNbrVolunteers
Total Gross UBI3827987TotalGrossUBI
Net Unrelated Business Txbl Income-1017948NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year130423ContributionsGrantsPriorYear
Contributions Grants Current Year9165492ContributionsGrantsCurrentYear
Program Service Revenue Prior Year227868169ProgramServiceRevenuePriorYear
Program Service Revenue CY225567987ProgramServiceRevenueCY
Investment Income Prior Year6310770InvestmentIncomePriorYear
Investment Income Current Year6129991InvestmentIncomeCurrentYear
Other Revenue Prior Year901828OtherRevenuePriorYear
Other Revenue Current Year1064217OtherRevenueCurrentYear
Total Revenue Prior Year235211190TotalRevenuePriorYear
Total Revenue Current Year241927687TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY139050GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year101684492SalariesEtcPriorYear
Salaries Etc Current Year103353571SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year3058TotalFundrsngExpCurrentYear
Other Expense Prior Year134781834OtherExpensePriorYear
Other Expenses Current Year135377209OtherExpensesCurrentYear
Total Expenses Prior Year236466326TotalExpensesPriorYear
Total Expenses Current Year238869830TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1255136RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3057857RevenuesLessExpensesCY
Total Assets BOY342865573TotalAssetsBOY
Total Assets EOY324301265TotalAssetsEOY
Total Liabilities BOY158862071TotalLiabilitiesBOY
Total Liabilities EOY162439194TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY184003502NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY161862071NetAssetsOrFundBalancesEOY
Mission DescriptionCRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO ENHANCING THE HEALTH STATUS OF THE INDIVIDUALS AND COMMUNITIES WE SERVE IN PARTNERSHIP WITH OUR PHYSICIANS, EMPLOYEES, AND COMMUNITY MEMBERS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense204519193Expense
Revenue221742737Revenue
DescriptionSEE SCHEDULE O PART III, LINE 4 DESCRIPTIONDescription
Total Program Service Expense204519193TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096259NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1888NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KIM HAUSCHILDBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2486525780TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11101 W UNIVERSITY DRIVEAddressLine1
CityROCHESTERCity
StateMIState
ZIP Code48307ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
BEVERLY ALLEN
TREASURER1.00X000
LISA ASADOORIAN
TRUSTEE1.00X000
BRYAN BARNETT
TRUSTEE1.00X000
MICHAEL BROWE
TRUSTEE1.00X000
PETER DESTEIGER
TRUSTEE1.00X000
ROBERT GOMD
TRUSTEE1.00X3251300
KENNETH JOHNSON
TRUSTEE1.00X000
KATHRIN KUDNER
TRUSTEE1.00X000
ROBERT LENIHANII
CHAIRMAN1.00X000
FREDERICK MAIBAUERMD
TRUSTEE1.00X310000
RUSSELL SHELTON
TRUSTEE1.00X000
F SCOTT MILLER
TRUSTEE1.00X000
ROBERT SKANDALARIS
TRUSTEE1.00X000
BRAD UPTON
TRUSTEE1.00X000
LYNN ORFGEN
PRESIDENT & CEO40.00436703043616X
AUDRIANNE MOCERI
SECRETARY40.0061510019221X
JEFFREY JENNINGSMD
CHIEF OF STAFF1.005625000X
CYNTHIA LONG
FORMER CFO40.00135656011649X
FRANK SOTTILE
CMO40.00368369051548X
GREGORY PARTAMIAN
COO40.00219289049124X
KATHLEEN VANWAGONER
CNO40.00219344050692X
MICHELLE HORNBERGER
CSO40.00140488039213X
DONNA KOPINSKI
CFO40.007684409029X
SAMAR KAZZIHA MD
EXECUTIVE MEDICAL DIRECTOR40.00473497027582X
DOUGLAS PUGMIRE DO
MEDICAL DIRECTOR ROBOTICS/GYN ONCOLOGY SERVICES40.00421886025299X
KEVIN FLOREK DO
MEDICAL DIRECTOR OCCUP MED40.00257364050671X
AMARBIR KHAIRA MD
RELIEF HOUSE PHYSICIAN40.0025105400X
NACIANCENO V WOO MD
HOUSE PHYSICIAN40.00208670042536X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3362537TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation420180TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BARTON MALOW-REWOLD LLC
26500 AMERICAN DRSOUTHFIELDMI48034CONSTRUCTION MANAGEMENT6761744
UNASOURCE SURGERY CENTERLLC
4550 INVESTMENT DR STE 100TROYMI48098SURGICAL SERVICES5359814
PATRIOT MEDICAL TECHNOLOGIES
MSC-410672 PO BOX 415000NASHVILLETN37241BIOMEDICAL SERVICES2064773
HARLEY ELLIS DEVEREAUX
PO BOX 674273DETROITMI48267ARCHITECTUAL SERVICES2030554
BALD MOUNTAIN SURGICAL CENTER LLC
1375 S LAPEER RD STE 109LAKE ORIONMI48360SURGICAL SERVICES1962355
FieldValueIRS element (for citing)
Number Of Contractors GT100 K60NumberOfContractorsGT100K
Fundraising Events500FundraisingEvents
Related Organizations9143378RelatedOrganizations
All Other Contributions21614AllOtherContributions
Total Contributions9165492TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE RE9000992241430232205919143551109
INVESTMENT IN JOINT VE900099665835391694274141
PROFESSIONAL FEES U-M900099250906250906
CPR CLASSES611600124643124643
KARMONOS ONCOLOGY REVE900099123928123928

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column259652TotalRevenueColumn
Related Or Exempt Function Income259652RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue225567987TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2636621TotalRevenueColumn
Exclusion$2,636,621ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities94788128Securities
Other3052326Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities92543985Securities
Other1803099Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2244143Securities
Other1249227Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3493370TotalRevenueColumn
Exclusion$3,493,370ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events43283GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events500CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses32699FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column10584TotalRevenueColumn
Exclusion$10,584ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory233540GrossSalesOfInventory
Cost Of Goods Sold141650CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column91890TotalRevenueColumn
Exclusion$91,890ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MEDICAL STAFF FUNCTION900099234114$234,114
MRI AND LAND LEASE900099201840$201,840
TV RENTAL900099168117$168,117

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column357672TotalRevenueColumn
Unrelated Business Revenue2737UnrelatedBusinessRevenue
Exclusion$354,935ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue961743TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column241927687TotalRevenueColumn
Related Or Exempt Function Income221742737RelatedOrExemptFunctionIncome
Unrelated Business Revenue3827987UnrelatedBusinessRevenue
Exclusion$7,191,471ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total139050Total
Program Services139050ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1876853Total
Management And General1876853ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total81291407Total
Program Services76009983ProgramServices
Management And General5281424ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4454939Total
Program Services4053104ProgramServices
Management And General401835ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8991391Total
Program Services8157798ProgramServices
Management And General833593ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6738981Total
Program Services6131125ProgramServices
Management And General607856ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total32500Total
Management And General32500ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total370343Total
Program Services3138ProgramServices
Management And General367205ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total232461Total
Management And General232461ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total55000Total
Management And General55000ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total63962Total
Management And General63962ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total40455558Total
Program Services36472096ProgramServices
Management And General3983462ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1062876Total
Program Services26118ProgramServices
Management And General1036758ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3760108Total
Program Services2311645ProgramServices
Management And General1447403ManagementAndGeneral
Fundraising1060Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8212126Total
Management And General8212126ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5076960Total
Program Services2078356ProgramServices
Management And General2998604ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total103427Total
Program Services53113ProgramServices
Management And General50314ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total24801Total
Program Services12658ProgramServices
Management And General10145ManagementAndGeneral
Fundraising1998Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2359132Total
Program Services2359132ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14770727Total
Program Services9565908ProgramServices
Management And General5204819ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total169618Total
Program Services145185ProgramServices
Management And General24433ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES3763411837030716603402
BAD DEBT1142614511426145
QAAP EXPENSE58972715897271
MALPRACTICE717435585833131602

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2952641Total
Program Services2060819ProgramServices
Management And General891822ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total238869830Total
Program Services204519193ProgramServices
Management And General34347579ManagementAndGeneral
Fundraising3058Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12687BOY
EOY12685EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY31655509BOY
EOY17990817EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY43237642BOY
EOY41194946EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4338541BOY
EOY3928146EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2851118BOY
EOY2471594EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis313418675LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec167691167LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY147340385BOY
EOY145727508EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY77599045BOY
EOY78648873EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY28439BOY
EOY47846EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY14314607BOY
EOY11249473EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY21487600BOY
EOY23029377EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY342865573BOY
EOY324301265EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY25898151BOY
EOY28784304EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY101980000BOY
EOY98610000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2223583BOY
EOY1595841EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY147845BOY
EOY17500EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY28612492BOY
EOY33431549EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY158862071BOY
EOY162439194EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY183159661BOY
EOY161034469EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY843841BOY
EOY827602EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY184003502BOY
EOY161862071EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY342865573BOY
EOY324301265EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3057857ReconcilationRevenueExpenses
Reconcilation Other Changes-25199288ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$55,000OtherActivitiesAmount
Total Lobbying Expenditures IIB55000TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationCRITTENTON HOSPITAL MEDICAL CENTER INDIRECTLY CONDUCTS LOBBYING ACTIVITIES THROUGHOUT THE YEAR. THE HOSPITAL HAS ENGAGED THE SERVICES OF A PROFESSIONAL LOBBYIST, WHO PERIODICALLY MEETS WITH FEDERAL, STATE, AND LOCAL LEGISLATORS TO DISCUSS ITEMS OF IMPORTANCE TO THE HOSPITAL AND HEALTH CARE INDUSTRY, AND ISSUES AFFECTING THE HEALTH CARE NEEDS OF THE COMMUNITY. THE EXPENDITURES LISTED IN PART II-B ARE FEES AND EXPENSE REIMBURSEMENTS PAID TO THE LOBBYIST DURING THE YEAR. ON RARE OCCASIONS, THE HOSPITAL ENCOURAGES ITS EMPLOYEES TO CONTACT LEGISLATORS TO CONSIDER CHANGES IN THE LAW THAT WOULD IMPROVE THE REGULATORY CLIMATE AFFECTING THE HEALTH CARE INDUSTRY AND ULTIMATELY, HEALTH CARE NEEDS OF THE COMMUNITY THE HOSPITAL SERVES. THE "GRASSROOT" LOBBYING IS INFREQUENT, AND INVOLVES NO SIGNIFICANT EXPENDITURES BY EITHER THE HOSPITAL OR ITS EMPLOYEES. NONE OF THIS ACTIVITY (DIRECT OR INDIRECT) INVOLVES POLITICAL CAMPAIGN ACTIVITY.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance843841BeginningOfYearBalance
Contributions219377Contributions
Investment Earnings Or Losses12055InvestmentEarningsOrLosses
Other Expenditures243647OtherExpenditures
Administrative Expenses4025AdministrativeExpenses
End Of Year Balance827601EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance964434BeginningOfYearBalance
Contributions167277Contributions
Investment Earnings Or Losses17908InvestmentEarningsOrLosses
Other Expenditures295562OtherExpenditures
Administrative Expenses10216AdministrativeExpenses
End Of Year Balance843841EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1026646BeginningOfYearBalance
Contributions152319Contributions
Investment Earnings Or Losses19315InvestmentEarningsOrLosses
Other Expenditures218961OtherExpenditures
Administrative Expenses14885AdministrativeExpenses
End Of Year Balance964434EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1062921BeginningOfYearBalance
Contributions168931Contributions
Investment Earnings Or Losses15719InvestmentEarningsOrLosses
Other Expenditures203894OtherExpenditures
Administrative Expenses17031AdministrativeExpenses
End Of Year Balance1026646EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2565744OtherCostOrOtherBasis
Book Value2565744BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis182076640OtherCostOrOtherBasis
Depreciation89054583Depreciation
Book Value93022057BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1732459OtherCostOrOtherBasis
Depreciation887455Depreciation
Book Value845004BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis109889986OtherCostOrOtherBasis
Depreciation75576013Depreciation
Book Value34313973BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17153846OtherCostOrOtherBasis
Depreciation2173116Depreciation
Book Value14980730BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings145727508TotalOfBookValueLandBuildings

Other Assets OtherAssets (13 entries)

DescriptionDescriptionBook ValueBookValue
15000 ACCOUNTS RECEIVABLE AFFILIATES1063796
14010 MISCELLANEOUS ACCOUNTS RECEIVABLE1557280
14300 ACCOUNTS RECEIVABLE POWERWORKS72336
14030 CASH RESTRICTED BY BOND COVENANTS-1867143
14090 DEBT SECURITIES4130089
8110-18140 DEBT ISSUANCE COST749915
18160 LONG TERM ACCOUNTS RECEIVABLE4220006
18170 ACCOUNTS RECEIVABLE KARMANOS585653
19010 ACCOUNTS RECEIVABLE SAAC6287318
14400 DUE FROM THIRD PARTY1067458
19110 PHYSICIAN LOAN FOREGIVENESS795154
19120 PHYSICIAN LOANS617515
19100 LOAN RECEIVABLE DOCTORS HOSPITAL3750000
FieldValueIRS element (for citing)
Total Book Value Other Assets23029377TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
SELF FUNDED MALPRACTICE INS CLAIMS LIABILITY$3,212,548
POST RETIREMENT HEALTH INS LIABILITY$579,986
PENSION LIABILITY$29,639,015
FieldValueIRS element (for citing)
Total Of Amounts33431549TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:Identifier
Return ReferencePART V, LINE 4:ReturnReference
ExplanationTHE ENDOWMENT FUNDS ARE USED FOR THE GIFT SHOP, THE AUXILLIARY AND THE HOSPITAL FOR GRANTS, SCHOLARSHIPS AND OTHER EXPENSES.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)

RegionRegionNumber Of OfficesNumberOfOfficesNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedSpecific Services ProvidedSpecificServicesProvidedTotal ExpendituresTotalExpenditures
CENTRAL AMERICA/CARIBBEAN00PROGRAM SERVICESINSURANCE536288
CENTRAL AMERICA/CARIBBEAN00INVESTMENT164489
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent700777SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent700777TotalAmountSpent
Transfer To Foreign Corp1TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp1OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SHEET SALENameOfEvent1
Gross Receipts Event113290GrossReceiptsEvent1
Gross Revenue Event113290GrossRevenueEvent1
Other Direct Expenses Event18842OtherDirectExpensesEvent1
Name Of Event2$6 SALENameOfEvent2
Gross Receipts Event210488GrossReceiptsEvent2
Gross Revenue Event210488GrossRevenueEvent2
Other Direct Expenses Event28565OtherDirectExpensesEvent2
Total Number Of Other Events14TotalNumberOfOtherEvents
Gross Receipts Other Events20005GrossReceiptsOtherEvents
Charitable Contrib Other Events500CharitableContribOtherEvents
Gross Revenue Other Events19505GrossRevenueOtherEvents
Other Direct Expenses Other Events15292OtherDirectExpensesOtherEvents
Gross Receipts Total43783GrossReceiptsTotal
Charitable Contributions Total500CharitableContributionsTotal
Gross Revenue Total Events43283GrossRevenueTotalEvents
Other Direct Expenses Total Events32699OtherDirectExpensesTotalEvents
Direct Expense Summary Events32699DirectExpenseSummaryEvents
Net Income Summary10584NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense544708TotalCommunityBenefitExpense
Net Community Benefit Expense544708NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense18509422TotalCommunityBenefitExpense
Direct Offsetting Revenue13093138DirectOffsettingRevenue
Net Community Benefit Expense5416284NetCommunityBenefitExpense
Percent Of Total Expense0.02380PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense234353TotalCommunityBenefitExpense
Direct Offsetting Revenue213871DirectOffsettingRevenue
Net Community Benefit Expense20482NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense19288483TotalCommunityBenefitExpense
Direct Offsetting Revenue13307009DirectOffsettingRevenue
Net Community Benefit Expense5981474NetCommunityBenefitExpense
Percent Of Total Expense0.02630PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1480NumberOfActivitiesOrPrograms
Persons Served24360PersonsServed
Total Community Benefit Expense554663TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense554663NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs870NumberOfActivitiesOrPrograms
Persons Served3318PersonsServed
Total Community Benefit Expense8184220TotalCommunityBenefitExpense
Direct Offsetting Revenue1502935DirectOffsettingRevenue
Net Community Benefit Expense6681285NetCommunityBenefitExpense
Percent Of Total Expense0.02940PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served50PersonsServed
Total Community Benefit Expense72800TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense72800NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs68NumberOfActivitiesOrPrograms
Persons Served11915PersonsServed
Total Community Benefit Expense108150TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense108150NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs2419NumberOfActivitiesOrPrograms
Persons Served39643PersonsServed
Total Community Benefit Expense8919833TotalCommunityBenefitExpense
Direct Offsetting Revenue1502935DirectOffsettingRevenue
Net Community Benefit Expense7416898NetCommunityBenefitExpense
Percent Of Total Expense0.03260PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs2420NumberOfActivitiesOrPrograms
Persons Served39643PersonsServed
Total Community Benefit Expense28208316TotalCommunityBenefitExpense
Direct Offsetting Revenue14809944DirectOffsettingRevenue
Net Community Benefit Expense13398372NetCommunityBenefitExpense
Percent Of Total Expense0.05890PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served1533PersonsServed
Total Community Building Expense1948TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense1948NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served1000PersonsServed
Total Community Building Expense21913TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense21913NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs76NumberOfActivitiesOrPrograms
Persons Served1555PersonsServed
Total Community Building Expense37485TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense37485NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs104NumberOfActivitiesOrPrograms
Persons Served4088PersonsServed
Total Community Building Expense61346TotalCommunityBuildingExpense
Net Community Building Expense61346NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$11,426,145BadDebtExpenseAmount
Amount Attributable To5713073AmountAttributableTo
Amount Reimbursed By Medicare67815398AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare75128123CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-7312725MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 USC LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivitySURGICAL CENTERDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.28700OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.71300PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CRITTENTON HOSPITAL MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11101 W UNIVERSITYAddressLine1
CityROCHESTERCity
StateMIState
ZIP Code48307ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CRITTENTON HOSPITAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1USC LLCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line14800 INVESTMENT DRIVE STE 370AddressLine1
CityTROYCity
StateMIState
ZIP Code48098ZIPCode
FieldValueIRS element (for citing)
Facility TypeSURGICAL CENTERFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: CRITTENTON HOSPITAL MEDICAL CENTER USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILTY FOR PROVIDING BOTH 'FREE' CARE AND 'DISCOUNTED' CARE TO LOW INCOME INDIVIDUALS. THE FAMILY INCOME LIMIT USED IS 200% FOR 'FREE' CARE AND 250% FOR 'DISCOUNTED' CARE.
PART I, LINE 7: THE COSTING METHOD USED FOR FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMS WAS A COST TO CHARGE RATIO FROM WORKSHEET 2 AND OTHER COMMUNITY BENEFITS WAS CALCULATED BASED UPON ACTUAL COST.
PART I, LINE 7G: CRITTENTON HOSPITAL MEDICAL CENTER DOES NOT HAVE ANY SUBSIDIZED HEALTH SERVICES TO REPORT.
PART I, L7 COL(F): THE BAD DEBT EXPENSE OF $11,426,145 WAS REMOVED FROM THE DENOMINATOR FOR THE CALCULATION OF THE PERCENT OF TOTAL EXPENSE.
PART II: COMMUNITY HEALTH LEADERSHIP AND OTHER SENIOR LEADERS ACTIVELY PARTICIPATE ON A BROAD RANGE OF COMMUNITY COALITIONS SUCH AS THE OLDER PERSON'S COMMISSION, ROCHESTER COMMUNITY SCHOOLS, ROCHESTER/AUBURN HILLS COMMUNITY COALITION, OAKLAND COUNTY OBESITY COALITION, REGION 2 NORTH, OAKLAND COUNTY MEDICAL CONTROL AUTHORITY, MICHIGAN DEPT OF COMMUNITY HEALTH, CROSSROADS PREGNANCY CENTER AND OTHERS. THIS PROVIDES ONGOING KNOWLEDGE OF VARYING COMMUNITY NEEDS AND ADJUSTS AS ECONOMIC, ENVIRONMENTAL, AND HEALTHCARE CHANGES OCCUR IN CRITTENTON'S KEY COMMUNITIES.THE VARIOUS PROGRAMS THAT CHMC OFFERS TO THE COMMUNITY HELP TO ENHANCE THE HEALTH STATUS BY EDUCATION, EARLY DETECTION, SCREENING, AND ACCESSIBILITY TO RESOURCES. WE RECEIVE MULTIPLY STORIES EVERY YEAR STATING THAT IF THEY HAD NOT HAD ATTENDED ONE OF OUR SCREENINGS THEN THEY MAY NOT HAVE PURSUED FURTHER MEDICAL CARE OR TREATMENT. THE SCREENING OR EDUCATION IS WHAT INCREASED THEIR AWARENESS AND ENCOURAGED THEM TO SEEK CARE AND THAT SCREENING OR ACTIVITY IS WHAT HELPED TO ENHANCE THEIR HEALTH.
PART III, LINE 4: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. THE HOSPITAL FOLLOWS THE POLICY OF PROVIDING HEALTH SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. CONSEQUENTLY, THE HOSPITAL PROVIDES HEALTH SERVICES FREE OF CHARGE OR AT AMOUNTS LESS THAN ITS FULL COSTS OF PROVIDING CARE TO CERTAIN CATEGORIES OF PATIENTS. THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED USING THE HISTORICAL PERCENTAGE BASED ON CHARITY CARE APPLICATIONS APPROVED.
PART III, LINE 8: AS A NON-PROFIT HOSPITAL, CRITTENTON HOSPITAL MEDICAL CENTER IS REQUIRED TO PROVIDE MINIMAL LEVELS OF COMMUNITY BENEFIT IN EXCHANGE FOR OUR TAX EXEMPT STATUS. THESE COMMUNITY BENEFITS INCLUDE HEALTH EDUCATION OPPORTUNITIES, CHARITY AND BAD DEBT WRITEOFFS, AND OUR LOSSES ON MEDICARE. IN KEEPING WITH OUR MISSION TO PROMOTE HEALTH IN THE COMMUNITY, WE PROVIDE CARE TO MEDICARE BENEFICIARIES AT A LOSS, THUS HELPING TO RELIEVE THE GOVERNMENT BURDEN OF TREATING THESE PATIENTS WHO MAY OTHERWISE HAVE THEIR ACCESS TO CARE LIMITED.
PART III, LINE 9B: IT IS THE POLICY OF CRITTENTON HOSPITAL MEDICAL CENTER TO REQUIRE PAYMENT IN FULL FOR ALL SERVICES RENDERED, WHICH ARE PATIENT PAY, UPON RECEIPT OF THEIR FIRST STATEMENT. THE PATIENT THEN HAS THIRTY DAYS TO REMIT PAYMENT IN FULL. THE BURDEN OF PROOF OF A PATIENT'S INABILITY TO PAY IN FULL IS THE RESPONSIBILITY OF THE PATIENT. IF THE PATIENT CAN PROVE AN INABILITY TO PAY THEIR DEBT IN FULL, PARTIAL PAYMENT ARRANGEMENTS CAN BE MADE. IT IS ALSO THE POLICY OF THE HOSPITAL TO PROVIDE THE PATIENT WITH INFORMATION REGARDING THE AVAILABILITY OF WHATEVER SOCIAL SERVICES MAY BE APPLICABLE FOR THE PATIENT. IN ADDITION, A CHARITY CARE APPLICATION MAY ALSO BE PROVIDED.
PART V, SECTION B, LINE 9: THE HOSPITAL TAKES PART AND ASSISTS PATIENTS IN QUALIFYING FOR THE COUNTY INDIGENT HOSPITALIZATION PROGRAM.CRITTENTON HOSPITAL MEDICAL CENTER
PART V, SECTION B, LINE 10: FINANCIAL COUNSELORS ARE ON SITE AND CONTACTED WHENEVER A PATIENT COMES INTO THE HOSPITAL WITHOUT INSURANCE. THESE COUNSELORS ASSIST THE PATIENTS IN QUALIFYING FOR COUNTY, STATE, FEDERAL OR HOSPITAL ASSISTANCE PROGRAMS.CRITTENTON HOSPITAL MEDICAL CENTER
PART V, SECTION B, LINE 19D: CRITTENTON HOSPITAL MEDICAL CENTER BILLS BASED UPON THE EMERGENCY ROOM CHARGEMASTER, NOT ON ANY PARTICULAR PAYERS CONTRACTED REIMBURSEMENT RATE. THE HOSPITAL WILL PROVIDE A 25% DISCOUNT TO ANY EMERGENCY ROOM PATIENT THAT REQUESTS ONE.CRITTENTON HOSPITAL MEDICAL CENTER
PART VI, LINE 2: THE ALLOCATION OF CRITTENTON'S RESOURCES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF COMMUNITY RESIDENTS ARE BASED ON COMMUNITY NEEDS THAT ARE IDENTIFIED BOTH THROUGH THE STRATEGIC PLANNING PROCESS AND THROUGH A YEARLY COMPREHENSIVE REVIEW OF COUNTY, STATE AND FEDERAL HEALTHCARE DATA BY CRITTENTON'S COMMUNITY HEALTH AND EDUCATION DEPARTMENT. COMMUNITY NEEDS INFORMATION IS GATHERED FROM BOTH THE CDC'S NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION BEHAVIORAL RISK FACTOR SURVEILLLANCE SYSTEMS AND THROUGH THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH. FOR EXAMPLE, IN 2008 THE NEED FOR A SCHOOL NURSE PROGRAM WAS IDENTIFIED WITH THE ROCHESTER COMMUNITY SCHOOLS. CRITTENTON'S COMMUNITY HEALTH AND EDUCATION DEPARTMENT DEVELOPED AND IMPLEMENTED THE PROGRAM WHICH NOW SERVES 14,000 STUDENTS AND MANAGES 450 MEDICAL MANAGEMENT PROGRAMS. IN 2009 AND AGAIN IN 2010, PARTICIPATION WITH THE ROCHESTER/AUBURN HILLS COALITION RESULTED IN CRITTENTON'S SPONSORING RACHEL'S CHALLENGE, A PROGRAM WHICH PROVIDES SUICIDE PREVENTION AND INTERVENTION AND IMPROVED PEER TO PEER CONFLICT MANAGEMENT SKILLS FOR AREA YOUTH.
PART VI, LINE 3: CRITTENTON HOSPITAL MEDICAL CENTER DOES A NUMBER OF THINGS IN ORDER TO EDUCATE AND/OR ASSIST A PATIENT IN RECEIVING OUTSIDE ASSISTANCE, INCLUDING THE FOLLOWING:1. SIGNAGE IS POSTED AT REGISTRATION POINTS AROUND THE HOSPITAL REGARDING ASSISTANCE AVAILABLE TO PAY FOR SERVICES AS WELL AS OUR UNCOMPENSATED SERVICES PROGRAM, HANDOUTS ARE GIVEN TO THE PATIENTS AND THE PROGRAM IS OUTLINED ON THE BACK OF EVERY STATEMENT THAT IS SENT TO THE PATIENT.2. FINANCIAL COUNSELORS ARE ON SITE THAT ARE CONTACTED EVERY TIME A PATIENT WITHOUT INSURANCE COMES INTO THE EMERGENCY ROOM OR IS ADMITTED TO THE HOSPITAL. IN THE PAST 12 MONTHS THE FINANCIAL COUNSELORS HAVE ASSISTED OVER 600 PATIENTS IN QUALIFYING FOR COUNTY, STATE, FEDERAL, OR HOSPITAL ASSISTANCE PROGRAMS.3. TAKE PART AND ASSIST PATIENTS IN QUALIFYING FOR THE COUNTY INDIGENT HOSPITALIZATION PROGRAM WHICH IS RUN DIRECTLY THROUGH THE HOSPITAL AND PLACES VIRTUALLY NO BURDEN OF ANY TYPE ON THE PATIENT IN ORDER TO BE QUALIFIED.4. ALL MANAGERS THAT DEAL WITH THE PUBLIC ARE DIRECTLY INFORMED OF OUR UNCOMPENSATED SERVICE PROGRAMS AND VERBALLY ASSIST PATIENTS WITH SUGGESTIONS AS WELL AS OUR CASHIERS HAVING ACCESS TO THE SAME INFORMATION AND TRAINING.5. OFFER ASSISTANCE TO NEWBORN MOTHERS WITHOUT INSURANCE IN THE FORM OF ASSISTANCE IN APPLYING FOR MEDICAID AND PROVIDING MINIMAL PAYMENT OPTIONS.
PART VI, LINE 4: CRITTENTON IS A 290 BED ACUTE CARE HEALTH FACILITY SERVING COMMUNITIES IN OAKLAND, MACOMB, AND LAPEER COUNTIES. THE ENTIRE SERVICE AREA ENCOMPASSES 35 ZIP CODES IN THREE REGIONS AND IS FURTHER SUBDIVIDED INTO THREE SECTORS: OUR CORE SECTOR WHICH ENCOMPASSES THE THREE ROCHESTER ZIP CODES, AND THE PRIMARY AND SECONDARY SECTORS. THE DEMOGRAPHIC SKEW FOR THE AREA IS SLIGHTLY OLDER THAN THE NORM WITH HIGHER HOUSEHOLD INCOMES.
PART VI, LINE 5: CRITTENTON HOSPITAL MEDICAL CENTER DOESN'T WANT TO FORGET THE IMPORTANT ROLE THE COMMUNITY PLAYS IN ITS SUCCESS. THE HOSPITAL IS ESPECIALLY GRATEFUL THAT THEY ARE ABLE TO GIVE BACK TO THE COMMUNITY THROUGH ESSENTIOAL HEALTHCARE SERVICES AND EDUCATION TO CATER TO THE UNMET NEEDS OF SO MANY IN ITS COMMUNITY. OFFERING ADVANCED CARE AND SERVICES IN ONE OF THE MANY WAYS CRITTENTON SERVES ITS COMMUNITY. CRITTENTON HAS PARTNERED WITH PREMIER ORGANIZATIONS TO FULFILL ITS MISSION OF ENHANCING THE HEALTH STATUS OF THE COMMUNITY, I.E. UNIVERSITY OF MICHIGAN, BARBARA ANN KARMANOS CANCER INSTITUTE, WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE AND OAKLAND UNIVERSITY SCHOOL OF NURSING ARE JUST A FEW.
PART VI, LINE 6: CRITTENTON HOSPITAL MEDICAL CENTER IS DEDICATED TO PROVIDING CARE TO ALL RESIDENTS OF THE COMMUNITY, REGARDLESS OF THEIR FINANCIAL STATUS. THROUGH UNCOMPENSATED CARE, GOVERNMENT SPONSORED HEALTH CARE, COMMUNITY HEALTH SERVICES AND DONATIONS THE HOSPITAL IS ABLE TO REACH OUT TO THE COMMUNITY. THE FOUNDATION IS THE FUNDRAISING ARM OF THE ORGANIZATION. THEY HAVE HOSTED EVENTS SUCH AS THE GOLF, TENNIS AND FUN WALK BENEFIT AND THE GOURMET GALA BENEFIT WHICH HAS RAISED MONEY FOR A VARIETY OF ENHANCEMENTS TO THE HOSPITAL. THE CRITTENTON VOLUNTEER AUXILIARY IS AN INTEGRAL PART OF THE HOSPITAL'S SUCCESS. THE GROUP CONTRIBUTES A GREAT DEAL OF TIME AND SERVICE TO FURTHER THE GOAL OF PROVIDING CLINICAL EXCELLENCE IN A COMFORTABLE,WELCOMING ENVIRONMENT. SOME OF THE SERVICES THAT THEY PROVIDE INCLUDE CLERICAL ASSISTANCE, ESCORTING PATIENTS AROUND THE FACILITY, AND GREETING FAMILIES AND VISITORS. THE CRITTENTON WELLNESS CENTER AND THE OLDER PERSONS COMMISSION HAVE COMBINED HEALTH, WELLNESS, EDUCATION AND ACTIVITIES ALL WITH THE OLDER PERSON IN MINDE. MEMBERSHIP IS FREE TO RESIDENTS OF ROCHESTER, ROCHESTER HILLS, AND OAKLAND TOWNSHIP WHO ARE OLDER THAN AGE FIFTY. CRITTENTON CANCER CENTER PROVIDES COMMUNITY MEMBERS WITH A NEW LOCAL RESOURCE FOR EXCEPTIONAL CANCER CARE. THE SERVICES INCLUDED AT THE CANCER CENTER ARE CHEMOTHERAPY AND INFUSION, IMAGING, AND RADIATION THERAPY.
MIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11101 W UNIVERSITYAddressLine1
CityROCHESTERCity
StateMIState
ZIP Code48307ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient382627336EINOfRecipient
IRC Section501(C)3IRCSection
Amount Of Cash Grant139050AmountOfCashGrant
Purpose Of GrantTO PROVIDE FINANCIAL SUPPORT AND FURTHER CHARITABLE ENDEAVORS.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LYNN ORFGEN
410709000259940220000216160480319000
CYNTHIA LONG
639680007168807747039020147305000
FRANK SOTTILE
36496400034050220000295480419917000
GREGORY PARTAMIAN
21278500065040220000271240268413000
KATHLEEN VANWAGONER
21716100021830220000286920270036000
MICHELLE HORNBERGER
13520500052830150000242130179701000
SAMAR KAZZIHA MD
45761701400001880000275820501079000
DOUGLAS PUGMIRE DO
42185400032000252990447185000
KEVIN FLOREK DO
25379200035720220000286710308035000
AMARBIR KHAIRA MD
251054000000000251054000
NACIANCENO V WOO MD
20666800020020219960205400251206000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3THE AUDIT COMMITTEE REVIEWS THE PERFORMANCE AGAINST THE GOALS SET FOR THE CEO. IN ADDITION THE AUDIT COMMITTEE PERFORMS A REVIEW OF THE TOTAL SALARY AGAINST MARKET STATISTICS. FROM THAT REVIEW, A RECOMMENDATION IS MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD AND THE BOARD FOR APPROVAL.
PART I, LINE 4ACYNTHIA LONG RECEIVED A SEVERANCE OF $71,424 DURING 2011. EMPLOYEE AND EMPLOYER HAVE MUTUALLY AGREED TO TERMINATE EMPLOYEE'S EMPLOYMENT, EFFECTIVE FEBRUARY 28, 2011. EMPLOYEE WILL BE PROVIDED NOTICE OF HER RIGHTS UNDER COBRA. IF EMPLOYEE ELECTS TO ACCEPT THE TERMS OF THIS AGREEMENT, THE EMPLOYER WILL PAY THE COBRA PREMIUMS THROUGH JULY 16, 2011. THE EMPLOYER AGREES TO PAY EMPLOYEE SEVERANCE PAY, TWO WEEKS FOR EVERY YEAR OF SERVICE IN THE AMOUNT MINUS NORMAL LAWFUL DEDUCTIONS FOR TAXES AND WITHHOLDING. FURTHERMORE, EMPLOYEE HAS NOT WAIVED, RELEASED OR DISCHARGED EMPLOYER FROM PROVIDING TO HER ANY VESTED RETIREMENT BENEFITS. . IN ADDITION EMPLOYER AGREES TO REIMBURSE EMPLOYEE $766.65 FOR NON-REFUNDABLE AIRFARE TO THE CAYMAN ISLANDS SCHEDULED ON BEHALF OF THE EMPLOYER.
PART I, LINE 5

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MICHIGAN STATE HOSPITAL FINANCE AUTHORITY
38288941759465E4Z32003-07-3052400000REFUNDED 2002B SERIES/ BUILDING EXPENSES000
MICHIGAN STATE HOSPITAL FINANCE AUTHORITY
38288941759465E5X72003-12-2321480000REIMBURSE PRIOR CAPITAL EXPENDITURES000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
524000004903731448593420051011
214800003306994663420031011

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminated
(no name)
010000
COMERICA
0110005.20000000000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE TAX RETURN IS PREPARED BY THE FINANCE DEPARTMENT, AND THEN IS SENT TO AN OUTSIDE CERTIFIED PUBLIC ACCOUNTANTS OFFICE WHERE THE RETURN IS REVIEWED. THE RETURN IS THEN GIVEN TO THE BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. AFTER THE REVIEW, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CTHE HOSPITAL POLICY STATES THAT ALL EMPLOYEES HAVE A CONTINUOUS OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST, AN ACTUAL IMPROPRIETY, AND/OR AN APPEARANCE OF IMPROPRIETY. EMPLOYEES AT THE MANAGER LEVEL AND ABOVE EACH SIGN A STATEMENT ON AN ANNUAL BASIS ACKNOWLEDGING THEIR UNDERSTANDING OF THE POLICY AND VERIFYING THEIR APPROPRIATE DISCLOSURE OF ANY CONFLICTS. ALL REPORTED CONFLICTS SHALL BE REVIEWED BY THE CEO IN CONJUCTION WITH THE COMPLIANCE OFFICER AND DEPARTMENT OF LEGAL AFFAIRS. IF IT IS DETERMINED THAT A CONFLICT EXISTS THE EMPLOYEEE SHALL DISCONTINUE ALL ACTIVITIES SURROUNDING THAT CONFLICT. THE EMPLOYEE MAY ALSO SEEK A WAIVER OF THE CONFLICT FROM THE CEO. CHMC ALSO HAS A QUESTIONNAIRE FOR INDIVIDUALS AND THEIR IMMEDIATE FAMILY MEMBERS, INCLUDING BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES REGARDING CONFICTS OF INTEREST AND THIS MUST BE SIGNED BY THE INDIVIDUALS. THE QUESTIONNAIRE INCLUDES THE FOLLOWING: 1. IDENTIFY YOUR SERVICE ON ANY BOARD OF DIRECTORS OR TRUSTEES OF ANY OF THE COMPANY'S WITH WHICH CHMC OR ANY OF ITS' AFFILIATES DOES BUSINESS. 2. IDENTIFY WHETHER YOU ARE ASSOCIATED DIRECTLY OR INDIRECTLY OR HOLD A POSITION OR FINANCIAL INTEREST IN ANY OUTSIDE ORGANIZATION OR CONCERN WITH WHICH CRITTENTON DOES BUSINESS. 3. IDENTIFY WHETHER YOU DIRECT, MANAGE,OR PROVIDE SERVICES OR CONSULTATION TO ANY OUTSIDE ORGANIZATION OR CONCERN THAT DOES BUSINESS WITH OR COMPETES WITH CRITTENTON. 4. IDENTIFY ANY ACTIVITIES IN WHICH YOU ARE ENGAGED THAT MIGHT BE REGARDED AS CONSTITUTING A POTENTIAL CONFLICT OF INTEREST WITH CRITTENTON. 5. DISCLOSE ANY DIRECT OR INDIRECT COMPENSATION THAT YOU RECEIVE, OR ANTICIPATE RECEIVING, FROM ANY PERSON, FIRM, CORPORATION, OR MARKET IN ANY WAY RELATED TO YOUR POSITION WITH CRITTENTON. IF AT ANY TIME THERE IS A MATTER UNDER CONSIDERATION WHICH MAY CREATE A DIRECT OR INDIRECT CONFLICT OF INTEREST, IT IS THE INDIVIDUAL'S OBLIGATION TO DISCLOSE THE FACTS SURROUNDING THE POSSIBLE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER OR DEPARTMENT OF HUMAN RESOURCES AND THAT THE INDIVIDUAL AGREES TO PROMPTLY REPORT ANY NEW SITUATIONS THAT REQUIRE DISCLOSURE UNDER THIS QUESTIONNAIRE. THERE IS A SIGNED WRITTEN AGREEMENT/DOCUMENTATION FOR ANY BOARD MEMBER OR OFFICER IF A CONFLICT OF INTEREST ARISES. CURRENTLY THERE HAVE NOT BEEN ANY RESTRICTIONS PLACED ON ANY BOARD MEMBER OR OFFICER AS AN ISSUE HAS NOT ARISEN TO WARRANT THIS.
FORM 990, PART VI, SECTION B, LINE 15ATHE AUDIT COMMITTEE REVIEWS THE PERFORMANCE AGAINST THE GOALS SET FOR THE CEO. IN ADDITION THE AUDIT COMMITTEE PERFORMS A REVIEW OF THE TOTAL SALARY AGAINST MARKET STATISTICS. FROM THAT REVIEW, A RECOMMENDATION IS MADE TO THE EXECUTIVE COMMITTEE OF THE BOARD AND THE BOARD FOR APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST OF THE INDIVIDUAL.
PART VII-LINE 1BCYNTHIA LONG AND DONNA KOPINSKI DEVOTED APPROXIMATELY 2 HOURS PER WEEK AT FOUNDATION. FRANK SOTTILE, LYNN ORFGEN AND DONNA KOPINSKI DEVOTED APPROXIMATELY 4 HOURS PER WEEK TO THE CANCER CENTER, WHILE MICHELLE HORNBERGER DEVOTED APPROXIMATELY 13 HOURS PER WEEK TO CRITTENTON DEVELOPMENT CORPORATION. LYNN ORFGEN ALSO DEVOTED APPROXIMATELY 4 HOURS PER WEEK TO CRITTENTON DEVELOPMENT CORPORATION.ESTIMATED HOURS PER WEEK OFFICERS, ETC DEVOTED TO RELATED ORGANIZATIONS
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -2,775,895. PRIOR PERIOD ADJUSTMENTS: -11,223,107. PENSION LIABILITY -7,002,914. CANCER CENTER ACQUISITION -4,159,952. NET ASSETS RELEASED FROM RESTRICTIONS -37,420. TOTAL TO FORM 990, PART XI, LINE 5: -25,199,288.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE ORGANIZATION DID NOT MAKE ANY SIGNIFICANT CHANGES IN THE PROCESS OF THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT AUDITOR.AUDIT OF FINANCIAL STATEMENTS
PART III, LINE 4ATHE HOSPITAL WAS INVOLVED IN A LARGE NUMBER OF VARIOUS TYPES OF COMMUNITY CARE PROJECTS, EITHER AS A PARTICIPANT OR A SPONSORING ORGANIZATION. THESE INCLUDE, BUT ARE NOT LIMITED TO: HEALTHY PREGNANCY, WOMEN'S HEALTHY HEART, NUTRITION, WEIGHT LOSS, HEALTHY AGING, CHILD SAFETY, HEALTH RISK APPRAISALS, SMOKING CESSATION, MANAGING STRESS, CPR, SLEEP DISORDER AND MEN'S HEALTH CLASSES FOR THE COMMUNITY. ALSO, FREE BLOOD PRESSURE SCREENINGS ARE MADE AVAILABLE TO THE COMMUNITY. A BEREAVEMENT PROGRAM IS OFFERED THROUGH THE OBSTETRICS DEPARTMENT FOR GRIEVING PARENTS OF INFANTS. A TRAVEL MEDICINE PROGRAM IS OFFERED FOR BUSINESS AND VACATION TRAVELS THROUGH THE OCCUPATIONAL MEDICINE DEPARTMENT. ANNUALLY, VOLUNTEERS FROM THE HOSPITAL PARTICIPATE AT THE ROCHESTER ARTS AND APPLES FESTIVAL, COLLECT GIFTS FOR THE ROCHESTER NEIGHBORHOOD HOUSE, COLLECT FOOD FOR THE MICHIGAN HARVEST GATHERING, PARTICIPATE IN THE NORTH OAKLAND AMERICAN HEART WALK, THE BROOKSIE WAY AND COATS FOR COLD. A PEDIATRIC URGENT CARE PROGRAM IS OFFERED FOR AFTER HOURS MEDICAL CARE FOR CHILDREN UNDER EIGHTEEN YEARS OF AGE. ADDITIONALLY, A GEROPSYCHIATRIC PROGRAM WAS STARTED TO ASSIST OLDER ADULTS WITH HEALTH CARE CHANGES. WOUND CARE SERVICES ARE ALSO OFFERED, INCLUDING HYPERBARIC TREATMENTS.PROGRAM SERVICE ACCOMPLISHMENTS
PART VI SECTION A LINE 9LYNN ORFGEN-1937 ARCHERS POINTE, ROCHESTER HILLS, MI 48306OFFICER WHO CANNOT BE REACHED AT THE ORGANIZATION'S MAILING ADDRESS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CRITTENTON HOSPITAL MEDICAL CENTER FOUNDATION
1101 W UNIVERSITY DRROCHESTERMI48307382627336SUPPORTINGMISECTION 501(C)(3)SCHEDULE A LINE 11ACRITTENTON HOSPITAL MEDICAL CENTER1
CRITTENTON CANCER CENTER
1901STAR BATT DRROCHESTER HILLSMI48309383239057SUPPORTINGMISECTION 501(C)(3)SCHEDULE A LINE 9CRITTENTON HOSPITAL MEDICAL CENTER1

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
CRITTENTON MEDICAL EQUIPMENT
161 S LIVERNOIS RDROCHESTER HILLSMI48307383433794MEDICAL EQUIPMENT SALESMICRITTENTON DEVELOPMENT CORPORATIONUNRELATED00
HBC INFUSIONS
1101 W UNIVERSITYROCHESTERMI48307753123093INFUSION SERVICESMICRITTENTON DEVELOPMENT CORPORATIONUNRELATED00
BALD MOUNTAIN SURGICAL CENTER
1375 S LAPEER RD STE 3109LAKE ORIONMI48360030444972SURGICAL SERVICESMICRITTENTON DEVELOPMENT CORPORATIONUNRELATED00

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
CRITTENTON DEVELOPMENT CORPORATION
2251 N SQUIRREL RD STE 310AUBURN HILLSMI48326382594115REAL ESTATEMICRITTENTON HOSPITAL MEDICAL CENTERC806168185186651.00000
CRITTENTON MEDICAL PHARMACY
1101 W UNIVERSITYROCHESTERMI48307203773341PHARMACY SALESMICRITTENTON DEVELOPMENT CORPORATIONC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CRITTENTON DEVELOPMENT CORP
N164551CASH
CRITTENTON CANCER CENTER
D12269512CASH
CHMC FOUNDATION
B139050CASH
CHMC FOUNDATION
C9143378CASH
CHMC FOUNDATION
K126628CASH
CHMC FOUNDATION
L353704CASH
CHMC FOUNDATION
P480319CASH
CRITTENTON CANCER CENTER
O811535CASH
CRITTENTON CANCER CENTER
P176987CASH

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