COREWELL HEALTH: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
COREWELL HEALTH (EIN 38-2748035)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-07-16
IRS object ID
201231989349300628
Schema version
2010v3.4
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)
Timestamp2012-07-16T12:11:01-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1511 RENAISSANCE DR SUITE 120AddressLine1
CityST JOSEPHCity
StateMIState
ZIP Code49085ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382748035EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY MEMORIAL HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone2699836501Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13425 LAKESHORE DRAddressLine1
CityST JOSEPHCity
StateMIState
ZIP Code49085ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTIMOTHY CALHOUNName
TitleVP - FINANCE/CFOTitle
Phone2699836501Phone
Date Signed2012-07-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKENLEY G PENNER CPAName
Phone2699828000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1LAKELAND CONTINUING CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIMOTHY CALHOUNNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13425 LAKESHORE DRAddressLine1
CityST JOSEPHCity
StateMIState
ZIP Code49085ZIPCode
FieldValueIRS element (for citing)
Gross Receipts8030675GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteLAKELANDHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN THE SOUTHWEST MICHIGAN AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees144TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year42ContributionsGrantsPriorYear
Contributions Grants Current Year60ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8187759ProgramServiceRevenuePriorYear
Program Service Revenue CY8028555ProgramServiceRevenueCY
Investment Income Prior Year855InvestmentIncomePriorYear
Investment Income Current Year2060InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year8188656TotalRevenuePriorYear
Total Revenue Current Year8030675TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4308235SalariesEtcPriorYear
Salaries Etc Current Year4421230SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3008299OtherExpensePriorYear
Other Expenses Current Year3024975OtherExpensesCurrentYear
Total Expenses Prior Year7316534TotalExpensesPriorYear
Total Expenses Current Year7446205TotalExpensesCurrentYear
Revenues Less Expenses Prior Year872122RevenuesLessExpensesPriorYear
Revenues Less Expenses CY584470RevenuesLessExpensesCY
Total Assets BOY6666247TotalAssetsBOY
Total Assets EOY7133235TotalAssetsEOY
Total Liabilities BOY2623693TotalLiabilitiesBOY
Total Liabilities EOY2506211TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4042554NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4627024NetAssetsOrFundBalancesEOY
Mission DescriptionTO BE SOUTHWESTERN MICHIGAN'S LEADER IN SAFE, HIGH QUALITY, PATIENT CENTERED, COMPASSIONATE, HEALTH-RELATED SERVICES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6446962Expense
Revenue8028555Revenue
DescriptionNURSING HOME OPERATIONS WERE PROVIDED TO 131 INPATIENTS AND 0 OUTPATIENTS.Description
Total Program Service Expense6446962TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
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 With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees144NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
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 Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
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 Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHUCK PIECHOCKIBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2694282416TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11234 NAPIER AVEAddressLine1
CityST JOSEPHCity
StateMIState
ZIP Code49085ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
LAURENCE HABENICHT MD
DIRECTOR1.00X000
EWANAH JOHNSON MD
DIRECTOR1.00X000
MICHAEL MORTIMORE
CHAIRMAN1.00X000X
DAVE VILLAGE
DIRECTOR1.00X000
LOREN B HAMEL MD
PRESIDENT & CEO1.00X06432109860X
LYNN KELLOGG
DIRECTOR1.00X000
KAY VARGA-SMITH
VICE CHAIRMAN1.00X000X
LYNN GRAY MD
DIRECTOR1.00X000
TIMOTHY CALHOUN
VP FINANCE & CFO1.00034475017954X
DENNIS MACK
VP FACILITY SERVICES1.00018618114594X
JOSEPH WASSERMAN
PRESIDENT & CEO (PART YEAR)1.00000X
JAMES SCHLAMAN
DIRECTOR REHAB & LONG TERM10.00014635610936X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1320497TotalReportableCompFrmRltdOrgs
Total Other Compensation53344TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHABCARE GROUP
PO BOX 503534ST LOUISMO631503534REHABILITATION SERVICES474865
WEST MICHIGAN SHARED
PO BOX 1134GRAND RAPIDSMI495011134LAUNDRY103905
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions60AllOtherContributions
Total Contributions60TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUDescription
Business Code621400BusinessCode
Total Revenue Column8028555TotalRevenueColumn
Related Or Exempt Function Income8028555RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue8028555TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column787TotalRevenueColumn
Exclusion$787ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1273Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other1273Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1273TotalRevenueColumn
Exclusion$1,273ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8030675TotalRevenueColumn
Related Or Exempt Function Income8028555RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,060ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3749672Total
Program Services3187221ProgramServices
Management And General562451ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total422143Total
Program Services354600ProgramServices
Management And General67543ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total249415Total
Program Services212003ProgramServices
Management And General37412ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total19251Total
Program Services16363ProgramServices
Management And General2888ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total740469Total
Program Services626991ProgramServices
Management And General113478ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total793731Total
Program Services674671ProgramServices
Management And General119060ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total112233Total
Program Services94276ProgramServices
Management And General17957ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total73160Total
Program Services61454ProgramServices
Management And General11706ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total219205Total
Program Services186324ProgramServices
Management And General32881ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total7604Total
Program Services6463ProgramServices
Management And General1141ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
QAAP ASSESSMENT778905778905
MISCELLANEOUS12886110824820613
BAD DEBTS7396473964
REPAIR AND MAINTENANCE30378255184860
PHYSICIAN FEES27605234644141

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total19609Total
Program Services16497ProgramServices
Management And General3112ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7446205Total
Program Services6446962ProgramServices
Management And General999243ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY36260BOY
EOY144787EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY531738BOY
EOY614300EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2439BOY
EOY3018EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5970857LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3681868LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2324305BOY
EOY2288989EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3771505BOY
EOY4082141EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6666247BOY
EOY7133235EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY100609BOY
EOY86578EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY1574357BOY
EOY1529770EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY948727BOY
EOY889863EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2623693BOY
EOY2506211EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4042554BOY
EOY4627024EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4042554BOY
EOY4627024EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6666247BOY
EOY7133235EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses584470ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
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)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3373CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15582CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2924CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year42CurrentTaxYearMinus1Year
Current Tax Year60CurrentTaxYear
Total21981Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6911262CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7630742CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7999044CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8187759CurrentTaxYearMinus1Year
Current Tax Year8028555CurrentTaxYear
Total38757362Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6914635CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7646324CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8001968CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8187801CurrentTaxYearMinus1Year
Current Tax Year8028615CurrentTaxYear
Total38779343Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50938779343PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18267CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5553CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1701CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year855CurrentTaxYearMinus1Year
Current Tax Year787CurrentTaxYear
Total27163Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years18267CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5553CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1701CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year855CurrentTaxYearMinus1Year
Current Tax Year787CurrentTaxYear
Total27163Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6932902CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7651877CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8003669CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8188656CurrentTaxYearMinus1Year
Current Tax Year8029402CurrentTaxYear
Total38806506Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99930PublicSupportPercentage509
Prior Year Support Percentage0.99900PriorYearSupportPercentage
Investment Income Percentage0.00070InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00100PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis162800OtherCostOrOtherBasis
Book Value162800BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4630517OtherCostOrOtherBasis
Depreciation2906139Depreciation
Book Value1724378BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1004811OtherCostOrOtherBasis
Depreciation714353Depreciation
Book Value290458BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis172729OtherCostOrOtherBasis
Depreciation61376Depreciation
Book Value111353BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2288989TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
BOND ISSUE COSTS52627
DUE FROM LAKELAND HOSPITALS AT NILES & ST. JOSEPH, INC.4029514
FieldValueIRS element (for citing)
Total Book Value Other Assets4082141TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED LIABILITIES$254,648
COST REPORT SETTLEMENT PAYABLE$635,215
FieldValueIRS element (for citing)
Total Of Amounts889863TotalOfAmounts
Total Revenue8030675TotalRevenue
Total Expenses7446205TotalExpenses
Excess Or Deficit For Year584470ExcessOrDeficitForYear
Excess Or Deficit Per FS584470ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationLAKELAND REGIONAL HEALTH SYSTEM, INC. AND ITS WHOLLY OWNED SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES EXCEPT FOR FOUR FLAGS HEALTH VENTURES, INC. D/B/A LAKELAND HEALTH ENTERPRISES AND SUBSIDIARIES, WHICH ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. INCOME TAX EXPENSE FOR THE FOR-PROFIT CORPORATIONS IS NOT SIGNIFICANT AND HAS BEEN INCLUDED IN OPERATING EXPENSES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY LAKELAND AND RECOGNIZE A TAX LIABILITY IF LAKELAND HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. LAKELAND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2008.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 (4 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
LOREN B HAMEL MD
049038201396500131780735002510065307000
TIMOTHY CALHOUN
027845405368301261301470003254036270400
DENNIS MACK
0154569027224043880950005094020077500
JAMES SCHLAMAN
014034201140048740846202474015729200

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationLAKELAND MAINTAINS A SUPPLEMENTAL RETIREMENT AND PRE-RETIREMENT DEATH BENEFIT PLAN FOR THE PURPOSE OF PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO EMPLOYEES WHO ARE ELIGIBLE UNDER THE TERMS AND CONDITIONS OF THE PLAN. THE PLAN IS INTENDED TO BE A NONQUALIFIED UNFUNDED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THE ANNUAL BENEFIT UNDER THE PLAN IS 1% OF FINAL AVERAGE PAY TIMES YEARS OF SERVICE (27.5 YEARS LIMIT) FOR PARTICIPANTS WHO HAVE ACHIEVED NORMAL RETIREMENT AGE OF 63 AND HAVE COMPLETED 10 YEARS OF SERVICE. THE ANNUAL BENEFIT IS PAID AS A LUMP SUM BASED ON 15 YEARS DISCOUNTED AT 6%. THERE IS NO BENEFIT EARNED OR PAID FOR PARTICIPANTS WHO SEPARATE FROM LAKELAND'S EMPLOYMENT BEFORE AGE 63. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE SERP ARE: TIM CALHOUN, LOREN HAMEL, AND DENNIS MACK.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE 990 WAS REVIEWED BY AN OFFICER OF THE BOARD AS WELL AS THE FINANCE AND HR COMMITTEE PRIOR TO FILING. A COPY OF THE 990 WAS PROVIDED TO THE OTHER BOARD MEMBERS PRIOR TO FILING.
THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN.FORM 990, PART VI, SECTION B, LINE 12C
THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
TIM CALHOUN, LOREN HAMEL, AND DENNIS MACK EACH WORKED AN AVERAGE OF AT LEAST 40 HOURS PER WEEK AND JAMES SCHLAMAN WORKED 20 HOURS PER WEEK AT THE RELATED ORGANIZATION FROM WHICH THEY WERE COMPENSATED.FORM 990, PART VII:
THERE HAS BEEN NO CHANGE IN AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:
THE CEO AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEOS COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2011.FORM 990, PART VI, SECTION B, LINE 15:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
LAKELAND HOSPITAL AT NILES AND ST JOSEPH INC
1234 NAPIER AVENUEST JOSEPHMI49085382156872PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITYMI501(C)(3)LINE 3LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND SPECIALITY HOSPITAL AT BERRIEN CENTER
1234 NAPIER AVENUEST JOSEPHMI49085383452303LONGTERM HEALTHCARE/HEALING SERVICESMI501(C)(3)LINE 3LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND HEALTH FOUNDATION BENTON HARBORST JOSEPH
1234 NAPIER AVENUEST JOSEPHMI49085382539929PROMOTE AND ASSIST IN PROVIDING HEALTH CAREMI501(C)(3)LINE 7LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND HEALTH FOUNDATION NILES
1234 NAPIER AVENUEST JOSEPHMI49085383130558PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGANMI501(C)(3)LINE 7LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND HEALTH SERVICES INC
1234 NAPIER AVENUEST JOSEPHMI49085203007464TO PROVIDE SKILLED PRIVATE NURSING CARE TO THE SOUTHWESTERN MICHIGAN AREAMI501(C)(3)LINE 9LAKELAND REGIONAL HEALTH SYSTEM INC1
HOME INFUSION SERVICES INC DBA LAKELAND HOME INFUSION
1234 NAPIER AVENUEST JOSEPHMI49085382969335PROVIDE IN-HOME INTRAVENOUS THERAPY SERVICESMI501(C)(3)LINE 9LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND REGIONAL HEALTH SYSTEM INC
1234 NAPIER AVENUEST JOSEPHMI49085382609624PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITYMI501(C)(3)LINE 11B, II0N/A
MERCY HEALTH CLINIC INC
1234 NAPIER AVENUEST JOSEPHMI49085383178765TO PROVIDE HEALTH CARE FOR THE COUNTY OF BERRIEN AND THE SURROUNDING AREAMI501(C)(3)LINE 3LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND COMMUNITY HOSPITAL - WATERVLIET
400 MEDICAL PARK DRIVEWATERVLIETMI49098381368745TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCAREMI501(C)(3)LINE 3LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND HOSPITAL AUXILIARY ST JOSEPH
1234 NAPIER AVENUEST JOSEPHMI49085383674457TO RENDER VOLUNTEER SERVICES TO LAKELAND REGIONAL HEALTH SYSTEM, ST JOSEPHMI501(C)(3)LINE 9LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND AUXILIARY BERRIEN GENERAL
6418 DEANS HILL ROADBERRIEN CENTERMI49102237025742TO RENDER SERVICE TO LAKELAND SPECIALTY HOSPITAL, BERRIEN CENTERMI501(C)(3)LINE 9LAKELAND REGIONAL HEALTH SYSTEM INC1
LAKELAND NILES AUXILIARY
1234 NAPIER AVENUEST JOSEPHMI49085386076112TO ENGAGE IN CHARITABLE ACTIVITIES TO ASSIST LKLD COMMUNITY HOSPITAL, NILESMI501(C)(3)LINE 9LAKELAND REGIONAL HEALTH SYSTEM INC1

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
LAKELINE ASSOCIATES LLC
910 S WASHINGTON AVENUEROYAL OAKMI48067383306318PROPERTY MANAGEMENT/RENTALMIN/A
CLIFFSIDE COMPANY LLC DBA CARETEL INNS OF ROYALTON
910 S WASHINGTON AVENUEROYAL OAKMI48067383306320ASSISTED LIVINGMIN/A
LIBERTY DIALYSIS LAKELAND LLC
7650 SE 27TH STREET SUITE 200MERCER ISLANDWA98040272099855MEDICAL SERVICESWAN/A
VAN'S MEDICAL EQUIPMENT OF LAKELAND LLC
1234 NAPIER AVENUEST JOSEPHMI49085261497708MEDICAL EQUIPMENTMIN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
NILES PROFESSIONAL SERVICES INC
31 NORTH ST JOSEPH AVENUENILESMI49120382633419MEDICAL ADMINISTRATIVE SERVICESMIN/AC
THE PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE
1234 NAPIER AVENUEST JOSEPHMI49085382929090PHARMACEUTICALSMIN/AC
FOUR FLAGS PROPERTIES INC
122 GRANT STREETNILESMI49120364501639PROPERTY MANAGEMENT/RENTALMIN/AC
LAKELAND PHYSICIAN CARE NETWORK
1234 NAPIER AVENUEST JOSEPHMI49085208513031MEDICAL SERVICESMIN/AC
LAKELAND MEDICAL PRACTICES
1234 NAPIER AVENUEST JOSEPHMI49085270381199MEDICAL ADMINISTRATIVE SERVICESMIN/AC
LAKELAND HEALTH ENTERPRISE INC
31 NORTH ST JOSEPH AVENUENILESMI49120382669798ACCOUNTING AND BILLINGMIN/AC
SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC
1234 NAPIER AVENUEST JOSEPHMI49085272589359PHYSICIAN OFFICEMIN/AC
LAKELAND PERSONAL CARE SERVICES INC
1234 NAPIER AVENUEST JOSEPHMI49085272990797HEALTH CARE SERVICESMIN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
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 Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1LAKELAND HOSPITAL OF NILES AND ST JOSEPH INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeNTransactionType
Amount Involved587579AmountInvolved
Method Of Amt DeterminationALLOCATION OF COSTMethodOfAmtDetermination

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