FURP.ORG / PUBLIC DATA EXPLORER

HOLLAND COMMUNITY HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HOLLAND COMMUNITY HOSPITAL (EIN 38-2800065)
Tax period
2010-04-01 to 2011-03-31
Filed
2012-03-13
IRS object ID
201240739349301409
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)
Timestamp2012-03-13T18:22:12-05:00Timestamp
Tax Period End Date2011-03-31TaxPeriodEndDate

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 Line1750 TRADE CENTRE WAY STE 300AddressLine1
CityPORTAGECity
StateMIState
ZIP Code49002ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382800065EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOLLAND COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLLNameControl
Phone6163925141Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1602 MICHIGAN AVENUEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code49423ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDALE SOWDERSName
TitlePRESIDENT & CEOTitle
Phone6163925141Phone
Date Signed2012-03-07DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameOLIVER JURKOVICName
Phone2695674500Phone
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 Line1HOLLAND HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonDALE SOWDERSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1602 MICHIGAN AVENUEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code49423ZIPCode
FieldValueIRS element (for citing)
Gross Receipts187183397GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HOLLANDHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO CONTINUOUSLY IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE IN THE SPIRIT OF HOPE, RESPECT, COMPASSION AND DIGNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees2125TotalNbrEmployees
Total Nbr Volunteers510TotalNbrVolunteers
Total Gross UBI1872592TotalGrossUBI
Net Unrelated Business Txbl Income235987NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year546534ContributionsGrantsPriorYear
Contributions Grants Current Year878365ContributionsGrantsCurrentYear
Program Service Revenue Prior Year162715545ProgramServiceRevenuePriorYear
Program Service Revenue CY175390965ProgramServiceRevenueCY
Investment Income Prior Year902669InvestmentIncomePriorYear
Investment Income Current Year-1249481InvestmentIncomeCurrentYear
Other Revenue Prior Year5935919OtherRevenuePriorYear
Other Revenue Current Year8221281OtherRevenueCurrentYear
Total Revenue Prior Year170100667TotalRevenuePriorYear
Total Revenue Current Year183241130TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year538055GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY770803GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year86869555SalariesEtcPriorYear
Salaries Etc Current Year91784339SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year72140438OtherExpensePriorYear
Other Expenses Current Year80341780OtherExpensesCurrentYear
Total Expenses Prior Year159548048TotalExpensesPriorYear
Total Expenses Current Year172896922TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10552619RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10344208RevenuesLessExpensesCY
Total Assets BOY315558594TotalAssetsBOY
Total Assets EOY355240131TotalAssetsEOY
Total Liabilities BOY73001654TotalLiabilitiesBOY
Total Liabilities EOY85527092TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY242556940NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY269713039NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO CONTINUOUSLY IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE IN THE SPIRIT OF HOPE, RESPECT, COMPASSION AND DIGNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense142977465Expense
Grants770803Grants
Revenue175390965Revenue
DescriptionHOLLAND COMMUNITY HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. THIS UNWAVERING COMMITMENT TO PROVIDING THE HIGHEST QUALITY MEDICAL CARE HAS REMAINED STEADFAST SINCE THE HOSPITAL BEGAN. THIS 95-YEAR LEGACY OF PROVIDING EXCELLENT, COMPASSIONATE AND INCREASINGLY ADVANCED HEALTH CARE REGARDLESS OF PATIENTS' ABILITY TO PAY CONTINUES UNABATED.FIRST-RATE QUALITY TODAY, HOLLAND HOSPITAL IS NATIONALLY RECOGNIZED FOR QUALITY AND EXCELLENCE AND IS THE PROUD RECIPIENT OF NUMEROUS STATE AND NATIONAL QUALITY AWARDS. IN 2007, HOLLAND HOSPITAL RECEIVED THE PRESTIGIOUS MAGNET HOSPITAL DESIGNATION, A FIRST-IN-CLASS DISTINCTION AWARDED BY THE AMERICAN NURSES CREDENTIALING CENTER TO HOSPITALS THAT DEMONSTRATE THE HIGHEST DEGREE OF PATIENT-CARE EXCELLENCE. FOR LAKESHORE-AREA RESIDENTS, OUR MAGNET INSIGNIA IS ASSURANCE THAT THE CARE PATIENTS RECEIVE AT HOLLAND HOSPITAL IS THE VERY BEST - AMONG THE TOP 3 PERCENT OF CLINICAL PROGRAMS IN THE NATION. TOP 100 HOSPITALS' FIVE YEARS AND COUNTINGTHIS YEAR WAS THE SIXTH CONSECUTIVE YEAR THAT HOLLAND HOSPITAL WAS RANKED AMONG THE NATION'S "100 TOP HOSPITALS" BY THOMSON REUTERS. THIS DISTINCTION IS BASED ON AN INDEPENDENT, DATA-DRIVEN REVIEW OF MORE THAN 3,000 HOSPITALS. HOSPITALS DON'T APPLY TO BE ON THIS LIST; RATHER, THE STUDY RATES THEM BASED ON A BALANCED, UNBIASED COMPARISON. ONLY THOSE THAT DEMONSTRATE SUPERIOR PERFORMANCE ARE CONSIDERED, AND ONLY THE BEST 100 MAKE THE LIST. OUR HOSPITAL IS ONE OF LESS THAN 40 HOSPITALS TO MAKE THE LIST SIX TIMES, VALIDATING THE HIGH QUALITY CARE HOLLAND HOSPITAL OFFERS - AND WORKS DAILY TO ACHIEVE.TOP 4 PERCENT FOR 'BEST PRACTICES'"PROCESS OF CARE MEASURES" (OR "CORE MEASURES") ARE PROVEN BEST-PRACTICE STANDARDS FOR TREATING PATIENTS WITH CERTAIN MEDICAL CONDITIONS. HOW WELL EACH HOSPITAL APPLIES THESE LIFE-SAVING MEASURES IS TRACKED BY THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES AND CAN BE VIEWED AT WWW.HOSPITALCOMPARE.HHS.GOV.RECENT DATA PLACE HOLLAND HOSPITAL AT THE 96TH PERCENTILE - MEANING WE'RE IN THE TOP 4 PERCENT OF HOSPITALS NATIONWIDE IN MEETING PROCESS OF CARE MEASURES. WE ARE ALSO AMONG THE FIRST HOSPITALS TO LEAD THE WAY IN PATIENT SAFETY THROUGH THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION KEYSTONE CENTER FOR PATIENT SAFETY & QUALITY. LEADERS IN INNOVATIVE PRACTICESTHE HOSPITAL CONTINUES TO MEET THE GROWING HEALTH CARE NEEDS OF THE COMMUNITY BY PROVIDING EXPERIENCED SPECIALISTS, LEADING-EDGE TECHNOLOGY AND EXCEPTIONAL PATIENT CARE. ALTHOUGH THE HEALTH CARE LANDSCAPE CONTINUES TO CHANGE, HOLLAND HOSPITAL REMAINS AHEAD OF THE CURVE WITH FISCAL DISCIPLINE, EFFICIENT USE OF RESOURCES, AND WISE INVESTMENT IN NEW TECHNOLOGIES. MANY LAKESHORE RESIDENTS ARE BENEFITING FROM OUR RECENT FACILITY IMPROVEMENTS AS WELL AS SUCH CUTTING-EDGE TECHNOLOGIES AS DAVINCI ROBOT-ASSISTED SURGERY, DIGITAL MAMMOGRAPHY AND INTERVENTIONAL RADIOLOGY. DURING FISCAL YEAR 2011, HOLLAND HOSPITAL'S 320-MEMBER MEDICAL STAFF, 1,900 EMPLOYEES AND 500 VOLUNTEERS SERVED THE COMMUNITY BY PROVIDING:PATIENT DAYS 29,700DISCHARGES 7,700BIRTHS 1,800SURGERIES 14,300OUTPATIENT VISITS 344,600EMERGENCY ROOM VISITS 41,700URGENT CARE VISITS 33,000HOME HEALTH VISITS 43,000LAB TESTS 632,000RADIOLOGY PROCEDURES 104,000BEDS 209INNOVATIVE OUTREACH PROGRAMSIMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE MEANS TAKING OUR SERVICES INTO THE COMMUNITY TO OFFER RESIDENTS CONVENIENT ACCESS TO HEALTH PROGRAMS AND EDUCATION. MORE PROGRAMS AND SERVICES ARE REACHING BEYOND HOSPITAL WALLS INTO THE COMMUNITY, WHETHER AT SCHOOLS, NEIGHBORHOODS OR BUSINESSES. RESIDENTS AND EMPLOYEES ALIKE CAN TAKE ADVANTAGE OF NUMEROUS PREVENTION AND WELLNESS OFFERINGS.HEALTH EDUCATION AND SERVICESRECOGNIZING THAT MEN AND WOMEN HAVE UNIQUE HEALTH NEEDS, HOLLAND HOSPITAL HAS RESPONDED TO THE COMMUNITY'S REQUEST FOR PROGRAMS THAT ADDRESS GENDER-RELATED HEALTH CONCERNS. OUR WOMEN'S MIDLIFE SERVICES IS DEVOTED ENTIRELY TO ADDRESSING THE PHYSICAL AND EMOTIONAL ISSUES OF MATURE WOMEN. CREATED BY WOMEN FOR WOMEN AND DIRECTED BY A CERTIFIED MENOPAUSE PRACTITIONER, WOMEN'S MIDLIFE SERVICES OFFERS THE LATEST INFORMATION ON MENOPAUSE AND RELATED ISSUES. INTERPRETATION SERVICESOUR ON-SITE INTERPRETERS, SPECIALLY TRAINED IN MEDICAL CONDITIONS IN ACCORDANCE WITH THE NATIONAL COUNCIL ON INTERPRETING IN HEALTH CARE, ARE AVAILABLE 24 HOURS A DAY TO FACILITATE COMMUNICATION BETWEEN PATIENTS AND PROVIDERS. IN THE PAST YEAR, STAFF HANDLED MORE THAN 23,500 INTERPRETATION REQUESTS. A NEW VIDEO CONFERENCING SYSTEM AT THE OFF-SITE URGENT CARE CENTER CONNECTS PATIENTS FACE-TO-FACE WITH INTERPRETERS IN MINUTES ELIMINATING DELAYS DUE TO TRAVEL TIME. DIABETES EDUCATION DIABETES IS A MAJOR HEALTH EPIDEMIC THAT WE CONTINUE TO ADDRESS THROUGH OUR DIABETES SELF-MANAGEMENT EDUCATION PROGRAM. WE ASSIST THOSE WITH DIABETES BY OFFERING INDIVIDUAL CONSULTATIONS AS WELL AS GROUP CLASSES. PARTICIPANTS LEARN ABOUT DIET AND NUTRITION, HOW TO TEST THEIR BLOOD SUGAR, AND MANAGING THE DISEASE WITH MEDICATION. COMMUNITY OUTREACH PROGRAMS THE CENTER FOR GOOD HEALTH OFFERS A WEALTH OF EDUCATIONAL CLASSES AND PRESENTATIONS FOR CHILDREN, ADULTS AND SENIORS. IN FY 2010, THE CENTER OFFERED 600 CLASSES AND EVENTS WITH APPROXIMATELY 11,000 PARTICIPANTS. RECENTLY, IN RESPONSE TO TODAY'S EMPHASIS ON IMPROVING WORKER HEALTH TO BOOST EFFECTIVENESS AND REDUCE HEALTH CARE COSTS, THE CENTER JOINED FORCES WITH MANY AREA BUSINESSES TO TAKE ITS WORKSITE WELLNESS PROGRAM DIRECTLY TO EMPLOYEES. SERVING THE UNDERSERVED WITH THE FACE OF HOLLAND PROJECTIN OTTAWA COUNTY, THE CHALLENGING ECONOMIC TIMES HAVE LEFT SOME 30,000 ADULTS AND CHILDREN WITH NO OR INSUFFICIENT HEALTH INSURANCE TO COVER THEIR FAMILY'S MEDICAL EXPENSES. IN RESPONSE, THE HOLLAND HOSPITAL FOUNDATION INTENSIFIED ITS EFFORTS TO "SERVE THE UNDERSERVED" BY FOCUSING FINANCIAL SUPPORT ON TWO VITAL PROGRAMS: THE HOLLAND COMMUNITY HEALTH CENTER AND THE SCHOOL NURSING PROGRAM. THE FOUNDATION IS THE SOLE SOURCE OF FUNDING FOR THE SCHOOL NURSING PROGRAM, INVESTING $50,000 PER SCHOOL YEARLY, AND CONTRIBUTED $750,000 TO THE OPERATION OF THE COMMUNITY HEALTH CENTER. HOLLAND COMMUNITY HEALTH CENTERDEMAND IS RISING DRAMATICALLY (BY ABOUT 800 PATIENTS PER YEAR) FOR SERVICES OF THE HOLLAND COMMUNITY HEALTH CENTER, WHICH PROVIDES HEALTH CARE FOR PEOPLE WHO ARE UNDER AND UNINSURED. IN 2010, THE COMMUNITY HEALTH CENTER SERVED NEARLY 4,731 PATIENTS, NEARLY HALF OF THEM CHILDREN WITH 10,724 VISITS. MOST OF THESE VISITS FOCUSED ON WOMEN'S AND CHILDREN'S HEALTH CARE NEEDS, DIABETES MANAGEMENT AND ELDER CARE. EACH YEAR THE COMMUNITY HEALTH CENTER ACQUIRES OVER $365,000 WORTH OF FREE MEDICATIONS FOR PATIENTS WHO CANNOT AFFORD THEM. THE SCHOOL NURSING PROGRAMSCHOOL NURSING PROVIDES SERVICES TO HOLLAND, WEST OTTAWA AND HAMILTON PUBLIC SCHOOLS. SCHOOL YEAR 2010-2011 THEY SERVICED 8,000 STUDENTS, 34,825 HEALTH OFFICE VISITS, ADMINISTERED 12,665 MEDICATIONS AND REFERRED 440 STUDENTS FOR MEDICAL, DENTAL, VISION, OR SOCIAL CONCERNS. THEY PROVIDED OVER 200 EDUCATIONAL SESSIONS. UNCOMPENSATED MEDICAL COSTS OUR COMMITMENT TO CARING FOR MEMBERS OF OUR COMMUNITY WHO ARE UNINSURED OR UNDERINSURED CONTINUES TO BE ONE OF THE BIGGEST FINANCIAL CHALLENGES FOR THE HOSPITAL. IN FY 2011, HOLLAND HOSPITAL PROVIDED UNREIMBURSED CARE TO OUR PATIENTS AT A COST OF $32.4 MILLION, A 16 PERCENT INCREASE OVER THE PREVIOUS YEAR. BAD DEBT ALONE STAYED CONSISTENT DURING 2011, ROSE OVER 30 PERCENT IN 2010 AND 50% IN 2009 - A REFLECTION OF THE CONTINUED ECONOMIC ENVIRONMENT AND GROWTH IN UNEMPLOYMENT.HOLLAND HOSPITAL TAKES ITS FIDUCIARY RESPONSIBILITY SERIOUSLY, AND WORKS VERY HARD TO BALANCE THE CURRENT HEALTH CARE NEEDS OF THE COMMUNITY WITH OUR RESPONSIBILITY TO REMAIN FINANCIALLY VIABLE FOR GENERATIONS TO COME. COMMUNITY OUTREACH IS AN IMPORTANT PART OF OUR MISSION AND IT TAKES GREAT EFFORT TO FREE UP RESOURCES TO BE ABLE TO INVEST IN THESE PROGRAMS AND COVER INCREASING COSTS FROM UNCOMPENSATED CARE.2011 COMMUNITY BENEFIT SUMMARY - $36.4 MILLION TOTAL COMMUNITY BENEFIT UNPAID COST OF MEDICAID $9,000,000UNPAID COST OF MEDICARE $6,500,000CHARITY CARE $6,700,000 BAD DEBT $10,200,000OTHER COMMUNITY BENEFITS (NOTE A) $4,000,000NOTE A - OTHER COMMUNITY BENEFITS INCLUDE:* COMMUNITY EDUCATION & OUTREACH PROGRAMS* CASH, IN-KIND DONATIONS & CONTRIBUTIONS* HOLLAND COMMUNITY HEALTH CENTER* HEALTH PROFESSIONAL EDUCATION & RESEARCHDescription
Total Program Service Expense142977465TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds1DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
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 Activities1FundraisingActivities
Gaming1Gaming
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 Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096166NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2125NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid1PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
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 Line1TERRY STEELEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6163925141TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1602 MICHIGAN AVEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code49423ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
DALE M SOWDERS
PRESIDENT & CEO40.00XXX5189570128941
LESLIE BROWN
TRUSTEE1.00X000
BARBARA DEPREE MD
PHYSICIAN, WOMEN'S MIDLIFE SERVICES30.00X160159020512
CHUCK DEPREE
TRUSTEE1.00X000
BECCA DERNBERGER
TRUSTEE1.00X000
WILLIAM FRAUENHEIM MD
MEDICAL DIRECTOR, CARDIOLOGY1.00X000
ROGER GAMACHE
TRUSTEE1.00X000
DON KOMEJAN
TRUSTEE1.00X000
KRIS MANOS
TRUSTEE1.00X000
GREG MAYBURY
TRUSTEE1.00X000
DAWN GARCIA WARD
TRUSTEE1.00X000
JANE CLARK
TRUSTEE1.00X000
JAMES STROOP
TRUSTEE1.00X000
MARK STID
CHIEF OF STAFF5.00XX936300
DAN RINK
TRUSTEE1.00X000
TERRY L STEELE
VP, FINANCE & CFO40.00X311306061907
CHARLES D KOHLRUSS
VP, HR & OPERATIONS SUPPORT40.00X247622051712
PATTI VANDORT
VP, NURSING & CNO40.00X251387047302
MARK L PAWLAK
VP, ANCILLARY SERVICES & QUALITY40.00X219247047346
WILLIAM L VANDERVLIET MD
VP, MEDICAL AFFAIRS20.00X124124032842
ROBERT J BATES MD
PHYSICIAN, UROLOGY40.00X549973041404
MICHAEL A TRAVER MD
PHYSICIAN, UROLOGY40.00X392403039344
BRADLEY L WILLOUGHBY MD
PHYSICIAN, UROLOGY40.00X360900039190
JOHN K LUDLOW MD
PHYSICIAN, UROLOGY40.00X404264020908
DERICK JOHNSON
PHYSICIAN40.00X18763903989
FieldValueIRS element (for citing)
Total Reportable Comp From Org3737344TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation535397TotalOtherCompensation
Number Individuals GT100 K52NumberIndividualsGT100K
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
LAKEWOOD CONSTRUCTION
11253 JAMES STREETHOLLANDMI49424CONSTRUCTION4055475
ARAMARK CORPORATION
12483 COLLECTIONS CENTER DRIVECHICAGOIL60693CONTRACTED SERVICES3362638
ELZINGA AND VOLKERS INC
86 E 6TH STHOLLANDMI49423CONSTRUCTION3041892
LAKESHORE CAMPUS LLC
161 OTTAWA AVENUE NW STE 104161 OGRAND RAPIDSMI49503LANDLORD - RENT899380
LAKESIDE ENT
577 MICHIGAN AVEHOLLANDMI49423BILLING SERVICES805456
FieldValueIRS element (for citing)
Number Of Contractors GT100 K31NumberOfContractorsGT100K
Fundraising Events182014FundraisingEvents
All Other Contributions696351AllOtherContributions
Total Contributions878365TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column175390965TotalRevenueColumn
Related Or Exempt Function Income175390965RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue175390965TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2178658TotalRevenueColumn
Exclusion$2,178,658ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real271673Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real271673Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column271673TotalRevenueColumn
Exclusion$271,673ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other459386Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other3887525Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-3428139Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-3428139TotalRevenueColumn
Exclusion-$3,428,139ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events75037GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events182014CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses27397FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column47640TotalRevenueColumn
Exclusion$47,640ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming20295GrossIncomeGaming
Gaming Direct Expenses27345GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column-7050TotalRevenueColumn
Exclusion-$7,050ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
MISCELLANEOUS REVENUE9000994734719$4,734,719
PHO/LAB ACTIVITY62150018725921872592
CAFETERIA AND HOME MEA722210904430$904,430

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column397277TotalRevenueColumn
Exclusion$397,277ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue7909018TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column183241130TotalRevenueColumn
Related Or Exempt Function Income175390965RelatedOrExemptFunctionIncome
Unrelated Business Revenue1872592UnrelatedBusinessRevenue
Exclusion$5,099,208ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total770803Total
Program Services770803ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2304413Total
Program Services186675ProgramServices
Management And General2117738ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total70091394Total
Program Services60391678ProgramServices
Management And General9699716ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1351842Total
Management And General1351842ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total18036690Total
Program Services17622251ProgramServices
Management And General414439ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1124650Total
Program Services4624ProgramServices
Management And General1120026ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total131700Total
Program Services20550ProgramServices
Management And General111150ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total704372Total
Management And General704372ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1244697Total
Program Services1244697ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total585362Total
Program Services30891ProgramServices
Management And General554471ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1034301Total
Program Services613589ProgramServices
Management And General420712ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2403038Total
Management And General2403038ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2658138Total
Program Services2653867ProgramServices
Management And General4271ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total310432Total
Program Services292448ProgramServices
Management And General17984ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total336487Total
Program Services197842ProgramServices
Management And General138645ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2175220Total
Program Services2175220ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9715604Total
Program Services8928726ProgramServices
Management And General786878ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1190975Total
Program Services65988ProgramServices
Management And General1124987ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES2706706826896663170405
CONTRACT LABOR1297434286066294367713
PROVISION FOR BAD DEBTS1017773510177735
OTHER4065083163524048731
UTILITIES24425762080237362339

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total172896922Total
Program Services142977465ProgramServices
Management And General29919457ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14558816BOY
EOY16963554EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9111669BOY
EOY7398459EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY19551882BOY
EOY27719373EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3210356BOY
EOY3404455EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2590516BOY
EOY1925640EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis205466677LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec88431937LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY108188679BOY
EOY117034740EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY125388579BOY
EOY158892019EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY31098572BOY
EOY19938178EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1859525BOY
EOY1963713EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY315558594BOY
EOY355240131EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10558229BOY
EOY14250975EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY59163091BOY
EOY66245245EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8200BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3272134BOY
EOY5030872EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY73001654BOY
EOY85527092EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY241860472BOY
EOY269017048EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY296468BOY
EOY295991EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY400000BOY
EOY400000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY242556940BOY
EOY269713039EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY315558594BOY
EOY355240131EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10344208ReconcilationRevenueExpenses
Reconcilation Other Changes16811891ReconcilationOtherChanges
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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Number DA Fs Held48NumberDAFsHeld
Donor Advised Contributions640615DonorAdvisedContributions
Grants Paid From Donor Funds641092GrantsPaidFromDonorFunds
Aggregate DAF Value297858AggregateDAFValue
Disclosed Orgs Legal Control1DisclosedOrgsLegalControl
Disclosed For Charitable Purposes1DisclosedForCharitablePurposes

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis7516110OtherCostOrOtherBasis
Book Value7516110BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis96654335OtherCostOrOtherBasis
Depreciation33848438Depreciation
Book Value62805897BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis12822444OtherCostOrOtherBasis
Depreciation625984Depreciation
Book Value12196460BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis88473788OtherCostOrOtherBasis
Depreciation53957515Depreciation
Book Value34516273BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings117034740TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENTS IN AFFILIATED ENTITIES2999986F
INVESTMENT IN JOINT VENTURE16938192F
FieldValueIRS element (for citing)
Total Of Book Value Securities19938178TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
PROFESSIONAL LIABILITY INSURANCE$2,876,128
COST REPORT SETTLEMENT PAYABLE$1,771,944
OTHER LONG-TERM LIABILITIES$382,800
FieldValueIRS element (for citing)
Total Of Amounts5030872TotalOfAmounts
Total Revenue183241130TotalRevenue
Total Expenses172896922TotalExpenses
Excess Or Deficit For Year10344208ExcessOrDeficitForYear
Net Unrealized GL On Investments14490505NetUnrealizedGLOnInvestments
Other$2,321,386OtherAmount
Total Adjustments16811891TotalAdjustments
Excess Or Deficit Per FS27156099ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt214765647TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments14490505NetUnrealizedGainsInvestments
Other Revenues14310245OtherRevenues
Revenue Not Rptd F99028800750RevenueNotRptdF990
Revenue Subtotal185964897RevenueSubtotal
Investment Expenses Not Included704372InvestmentExpensesNotIncluded
Other Revenues Not Included-3428139OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-2723767RevenueNotRptdOnFinStmt
Total Revenue Per Form990183241130TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt189542125TotExpensesEtcAuditedFinclStmt
Other Expenses Included17349575OtherExpensesIncluded
Expenses Not Rptd F99017349575ExpensesNotRptdF990
Expenses Subtotal172192550ExpensesSubtotal
Investment Expenses Not Included2704372InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt704372ExpensesNotRptdOnFinStmt
Total Expenses Per Form990172896922TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL HAS ADOPTED ACCOUNTING STANDARDS RELATED TO UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, REVIEWED ALL TAX POSITIONS. THE EVALUATED POTENTIAL EXPOSURE RELATED TO UNCERTAIN TAX POSITIONS WAS FOUND TO BE IMMATERIAL.
PART XI, LINE 8 - OTHER ADJUSTMENTS:UNREALIZED LOSS IN JOINT VENTURE 2,712,613. TRANSFER TO AFFILIATE -391,227.
PART XII, LINE 2D - OTHER ADJUSTMENTS:REVENUE FROM ENTITIES NOT REPORTED ON THIS RETURN 12,472,632. UNREALIZED LOSS IN JOINT VENTURE -875,000. ELIMINATIONS FOR EARNINGS IN OTHER ENTITIES 2,712,613.
PART XII, LINE 4B - OTHER ADJUSTMENTS:ASSET DISPOSAL RECLASSIFIED FROM EXPENSE -3,428,139.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES FROM ENTITIES NOT REPORTED ON THIS RETURN 14,796,436. ASSET DISPOSAL RECLASSIFIED FROM EXPENSE 3,428,139. UNREALIZED LOSS IN JOINT VENTURE -875,000.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1CULINARY CABARETNameOfEvent1
Gross Receipts Event1152841GrossReceiptsEvent1
Charitable Contributions Event195317CharitableContributionsEvent1
Gross Revenue Event157524GrossRevenueEvent1
Other Direct Expenses Event19884OtherDirectExpensesEvent1
Name Of Event2GALANameOfEvent2
Gross Receipts Event2104210GrossReceiptsEvent2
Charitable Contributions Event286697CharitableContributionsEvent2
Gross Revenue Event217513GrossRevenueEvent2
Rent Facility Costs Event2750RentFacilityCostsEvent2
Other Direct Expenses Event216763OtherDirectExpensesEvent2
Gross Receipts Total257051GrossReceiptsTotal
Charitable Contributions Total182014CharitableContributionsTotal
Gross Revenue Total Events75037GrossRevenueTotalEvents
Rent Facility Costs Total Events750RentFacilityCostsTotalEvents
Other Direct Expenses Total Events26647OtherDirectExpensesTotalEvents
Direct Expense Summary Events27397DirectExpenseSummaryEvents
Net Income Summary47640NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming20295GrossRevenueOtherGaming
Non Cash Prizes Other Gaming20625NonCashPrizesOtherGaming
Rent Facility Costs Other Gaming6720RentFacilityCostsOtherGaming
Volunteer Labor Other Gaming1VolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming0.95000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming20295GrossRevenueTotalGaming
Non Cash Prizes Total Gaming20625NonCashPrizesTotalGaming
Rent Facility Costs Total Gaming6720RentFacilityCostsTotalGaming
Direct Expense Summary Gaming27345DirectExpenseSummaryGaming
Net Gaming Income Summary-7050NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedMIStatesWhereGamingConducted
Licensed1Licensed
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers1GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Own Facility0.00000PercentageOfGamingOwnFacility
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonCOLLEEN PERDOKNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1602 MICHIGAN AVEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code49423ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonCOLLEEN PERDOKGamingManagerNamePerson
Gaming Manager Compensation0GamingManagerCompensation
Gaming Manager Services ProvidedFOUNDATION COORDINATORGamingManagerServicesProvided
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib Required0CharitableDistribRequired

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE G, PART III, LINE 16:ReturnReference
ExplanationINCLUDED IN COLLEEN PERDOK'S RESPONSIBILITIES IS THE ROLE OF GAMING MANAGER HOWEVER THE AMOUNT OF COMPENSATION ALLOCATED TO THIS ROLE IS MINIMAL.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3017831TotalCommunityBenefitExpense
Net Community Benefit Expense3017831NetCommunityBenefitExpense
Percent Of Total Expense0.01750PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense21920061TotalCommunityBenefitExpense
Direct Offsetting Revenue18501429DirectOffsettingRevenue
Net Community Benefit Expense3418632NetCommunityBenefitExpense
Percent Of Total Expense0.01980PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense24937892TotalCommunityBenefitExpense
Direct Offsetting Revenue18501429DirectOffsettingRevenue
Net Community Benefit Expense6436463NetCommunityBenefitExpense
Percent Of Total Expense0.03730PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense178642TotalCommunityBenefitExpense
Direct Offsetting Revenue38696DirectOffsettingRevenue
Net Community Benefit Expense139946NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense288886TotalCommunityBenefitExpense
Net Community Benefit Expense288886NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense411877TotalCommunityBenefitExpense
Direct Offsetting Revenue341836DirectOffsettingRevenue
Net Community Benefit Expense70041NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense2405887TotalCommunityBenefitExpense
Net Community Benefit Expense2405887NetCommunityBenefitExpense
Percent Of Total Expense0.01390PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3285292TotalCommunityBenefitExpense
Direct Offsetting Revenue380532DirectOffsettingRevenue
Net Community Benefit Expense2904760NetCommunityBenefitExpense
Percent Of Total Expense0.01680PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense28223184TotalCommunityBenefitExpense
Direct Offsetting Revenue18881961DirectOffsettingRevenue
Net Community Benefit Expense9341223NetCommunityBenefitExpense
Percent Of Total Expense0.05410PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense4560TotalCommunityBuildingExpense
Net Community Building Expense4560NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense746807TotalCommunityBuildingExpense
Direct Offsetting Revenue224772DirectOffsettingRevenue
Net Community Building Expense522035NetCommunityBuildingExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense478229TotalCommunityBuildingExpense
Net Community Building Expense478229NetCommunityBuildingExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Total Community Building Expense1229596TotalCommunityBuildingExpense
Direct Offsetting Revenue224772DirectOffsettingRevenue
Net Community Building Expense1004824NetCommunityBuildingExpense
Percent Of Total Expense0.00580PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$4,587,309BadDebtExpenseAmount
Amount Attributable To727432AmountAttributableTo
Amount Reimbursed By Medicare24761006AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare28997643CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4236637MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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 Line1HOLLAND HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1602 MICHIGAN AVEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code49423ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Er OtherXErOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HH SERVICES LLC
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
HH SERVICES - STAGEMAN LLC
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
HH SERVICES - BATES ET AL LLC
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
HH SERVICES - HOLLAND PROFESSIONAL SERVI
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
HH SERVICES - ORT LLC
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
HOLLAND HOSPITAL PHYSICIAN CLINIC
602 MICHIGAN AVEHOLLANDMI49423NOT ACTIVE
HH SERVICES - SOUTH WASHINGTON
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
HH SERVICES SOUTH WASHINGTON
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
LAKESHORE HEALTH PARTNERS - FAMILY MED
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE
LAKESHORE HEALTH PARTNERS
602 MICHIGAN AVEHOLLANDMI49423PHYSICIAN OFFICE

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART II: THE HEALTH OF OUR COMMUNITY IS SIMPLY A REFLECTION OF THE HEALTH OF EACH INDIVIDUAL WITHIN OUR COMMUNITY. TO ACHIEVE THE HIGHEST LEVEL OF PERSONAL HEALTH, INDIVIDUALS MUST HAVE ACCESS TO THE APPROPRIATE TOOLS, BEST HEALTH INFORMATION AND LOCAL MEDICAL EXPERTISE. OUR OUTREACH TO THE COMMUNITY PROVIDES ACCESS TO THESE VITAL COMPONENTS. FROM HEALTH SCREENINGS AND COMMUNITY PRESENTATIONS TO CHARITABLE CARE FOR THE UNINSURED/UNDERINSURED, OUR GOAL IS TO HELP EACH INDIVIDUAL REACH HIS/HER MAXIMUM PERSONAL HEALTH POTENTIAL AND, IN THE PROCESS, CREATE AN OVERALL HEALTHIER COMMUNITY.
PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. TO DETERMINE BAD DEBTS AT COST, THE COST TO CHARGE RATIOS FROM THE 3/31/10 MEDICARE COST REPORT FOR IP, OP AND PSYCH WERE APPLIED TO EACH OF THE RESPECTABLE BAD DEBT TOTALS FROM WORKSHEET E FROM THE COST REPORT AND AN AVERAGE COST TO CHARGE RATIO DERIVED. THIS RATIO THEN WAS APPLIED TO THE TOTAL BAD DEBT (NOT INCLUDING CHARITY CARE) EXPENSE FROM THE TRIAL BALANCE TO COME UP WITH AN ESTIMATION OF BAD DEBTS AT COST.THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. THE HOSPITAL ALSO MAINTAINS RECORDS OF THE COST OF SERVICES PROVIDED TO MEDICARE AND MEDICAID RECIPIENTS NOT COVERED BY GOVERNMENTAL REIMBURSEMENT AS WELL AS THE COST OF OTHER PROGRAMS DESIGNED TO PROMOTE COMMUNITY HEALTH NOT COVERED BY INSURANCE. TRADITIONAL CHARITY CARE COVERS SERVICES PROVIDED TO PEOPLE WHO CANNOT AFFORD TO PAY. CHARITY CARE IS DETERMINED BASED ON ESTABLISHED POLICIES, USING PATIENT INCOME AND ASSETS TO DETERMINE PAYMENT ABILITYTHERE IS A POTENTIAL THAT SOME ACCOUNTS WRITTEN OFF AS BAD DEBTS COULD HAVE BEEN ELIGIBLE UNDER THE ORGANIZATIONS CHARITY CARE POLICY, HOWEVER DUE TO INADEQUATE APPLICATIONS FILED OR NEVER RETURNED GET WRITTEN OFF TO BAD DEBTS INSTEAD. THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS APPROXIMATELY $46,000. THIS WAS DERIVED BY REVIEWING NOTES ON FILES FOR POTENTIAL CHARITY CARE CASES FOR THE LAST QUARTER OF THE YEAR AND APPLYING THAT AVERAGE TO THE TOTAL POPULATION AND THEN APPLYING THE COSTING METHODOLOGY DISCUSSED ABOVE.
PART III, LINE 8: COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS 990 INSTRUCTIONS. THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT DUE TO ITS REPRESENTATION OF COST OF A PORTION OF SERVICES PROVIDED TO THE COMMUNITY WITHOUT PAYMENT.
PART III, LINE 9B: ANY BALANCE DEEMED PATIENT RESPONSIBILITY (AFTER INSURANCE PAYMENT/DETERMINATION AND AFTER ANY APPLICABLE DISCOUNT OR CHARITY) IF NOT PAID WILL RECEIVE A MINIMUM OF 2 STATEMENTS. AT DAY 60 AN EARLY OUT AGENCY WORKS THE ACCOUNT FOR HOLLAND HOSPITAL A MINIMUM OF 90 DAYS. THE ACCOUNT WILL BE HELD ON HOLLAND HOSPITAL'S "BOOKS" UNTIL IT HAS AGED TO A MINIMUM OF 180 DAYS FROM DISCHARGE. AT THIS TIME THE ACCOUNT IS ELIGIBLE AND WILL BE REVIEWED TO BE SENT TO A COLLECTION AGENCY.
HOLLAND HOSPITAL IS COMMITTED TO SERVING THE HEALTH CARE NEEDS OF EVERY PERSON IN OUR COMMUNITY. WE DO SO WILLINGLY. IT IS OUR RESPONSIBILITY TO HELP INDIVIDUALS PREVENT ILLNESS, RECOVERY FROM INJURY, AND IMPROVE THEIR OVERALL HEALTH STATUS. WE TAKE THAT RESPONSIBILITY VERY SERIOUSLY. THE COMMUNITY BENEFITS WE PROVIDE THROUGH DIRECT MEDICAL CARE, OUTREACH AND EDUCATION ARE AN INVESTMENT IN OUR COMMUNITY'S WELL BEING. IT'S AN INVESTMENT TOWARD A BETTER FUTURE FOR THOSE WE SERVE.
PART VI, LINE 2: IN COLLABORATION WITH THE OTTAWA COUNTY HEALTH DEPARTMENT AND THE UNITED WAY, A COMMUNITY ASSISSMENT IS PERFORMED. THE UNITED WAY PUBLISHES THEIR ASSESSMENT EVERY 5 YEARS (LAST ONE IN 2008) AND THE OTTAWA COUNTY HEALTH DEPARTMENT PUBLISHES THEIR YOUTH ASSESSMENT EVERY 2 YEARS (LAST ONE IN 2008) AND EVERY 3 YEARS FOR ADULTS (LAST ONE IN 2007)
PART VI, LINE 3: OUR FINANCIAL ASSISTANCE PROGRAM IS LOCATED ON OUR WEBSITE. ALSO, OUR COLLECTORS, CUSTOMER SERVICE EMPLOYEES, OR ANY OTHER HOLLAND HOSPITAL EMPLOYEE WITH WHOM THE PATIENT MIGHT HAVE CONTACT, OUR MEDICAID ELIGIBILITY VENDOR, AND THE EARLY OUT AGENCIES INFORM PATIENTS OF THE POLICY. ALL OF THE ABOVE MENTIONED SOURCES CAN AND DO MAIL FINANCIAL ASSISTANCE APPLICATIONS TO THE PATIENTS FOR CONVENIENCE.
PART VI, LINE 4: HOLLAND HOSPITAL'S PRIMARY SERVICE AREA (PSA) CONSISTS OF EIGHT ZIP CODES THAT FALL WITHIN ALLEGAN AND OTTAWA COUNTIES OF MICHIGAN. WE ALSO SERVE RESIDENTS IN OUR EXTENDED SERVICE AREA (ESA) WHICH TOGETHER WITH THE PSA COMPRISES A TOTAL POPULATION OF NEARLY 250,000. OUR PSA POPULATION COMPRISES ALL AGE GROUPS, SKEWING OLDER IN THE CITY OF HOLLAND AND YOUNGER IN THE GROWING AREAS OUTSIDE THE CITY. THE AREA ALSO ENCOMPASSES A WIDE RANGE OF RACIAL AND ETHNIC BACKGROUNDS. THE CITY OF HOLLAND DIFFERS SUBSTANTIALLY FROM THE SURROUNDING COUNTIES IN RACIAL/ETHNIC COMPOSITION. OVER 22% OF HOLLAND CITY RESIDENTS ARE HISPANIC/LATINO, CONTRASTED WITH ABOUT 6-8% IN OTTAWA AND ALLEGAN COUNTIES. HOLLAND ALSO SHOWS A GREATER PERCENTAGE OF ASIAN RESIDENTS (3.6%) THAN OTHER AREAS OF THE STATE AND PROPORTIONALLY MORE BLACK/AFRICAN AMERICANS (2.5%) LIVE IN HOLLAND THAN IN ADJACENT COUNTIES.
PART VI, LINE 6: HOLLAND HOSPITAL, ALONG WITH OTHER MICHIGAN HOSPITALS, PROVIDES DIRECT PATIENT CARE TO THOSE WHO CANNOT AFFORD IT. THOUGH THE AMOUNT OF CHARITABLE CARE AND BAD DEBT HAS RISEN STEEPLY IN THE PAST FEW YEARS DUE PRIMARILY TO A STRUGGLING ECONOMY, HOLLAND HOSPITAL HAS REMAINED TRUE TO ITS MISSION TO CONTINUALLY IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE IN THE SPIRIT OF HOPE, COMPASSION, RESPECT AND DIGNITY. AROUND-THE-CLOCK MEDICAL CARE IS AVAILABLE TO ALL IN NEED. ADDITIONAL URGENT CARE SERVICES HAVE BEEN ADDED AND COMMUNITY HEALTH OUTREACH EFFORTS HAVE BEEN INCREASED. ALL OF THIS HAS BEEN DONE TO ENHANCE THE WELL BEING OF THE COMMUNITY, WITH LITTLE OR NO COST TO THOSE WE SERVE.
MIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
COMMUNITY HEALTH CENTER
602 MICHIGAN AVENUEHOLLANDMI49423200602574501(C)(3)7468040N/AN/AOPERATIONAL CASH FLOW TO BREAK-EVEN
LAKESHORE ADVANTAGE CORP
201 W WASHINGTONZEELANDMI49464061708014501(C)(3)100000N/AN/AFINANCIAL CONTRIBUTIONS 2011
UNIVERSITY OF MICHIGAN
3003 SOUTH STADIUMANN ARBORMI4810938600630911595000N/AN/AFINANCIAL CONTRIBUTIONS 2011
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE HOSPITAL RECIEVES THEIR MONTHLY INTERNAL FINANCIALS AND A COPY OF THE AUDITED STATEMENTS ANNUALLY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
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 (12 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
DALE M SOWDERS
39686401085160135770729320560090647898000
BARBARA DEPREE MD
160009015000000205120180671000
TERRY L STEELE
2273440496650342970227270391800373213000
CHARLES D KOHLRUSS
1807520394860273840125970391150299334000
PATTI VANDORT
1750320382360381190135400337620298689000
MARK L PAWLAK
173867037979074010123060350400266593000
WILLIAM L VANDERVLIET MD
1241240000065460262960156966000
ROBERT J BATES MD
5499730000000414040591377000
MICHAEL A TRAVER MD
3924030000000393440431747000
BRADLEY L WILLOUGHBY MD
3609000000000391900400090000
JOHN K LUDLOW MD
4042640000078550130530425172000
DERICK JOHNSON
187639000002722012670191628000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MICHIGAN STATE HOSPITAL FINANCE AUTHORTIY
38288941759465E7A52004-08-0121744478CONSTRUCTION OF NEW BUILDING000
MICHIGAN STATE HOSPITAL FINANCE AUTHORTIY
38288941759465E7A52004-08-0122000000CONSTRUCTION OF NEW BUILDING000
MICHIGAN STATE HOSPITAL FINANCE AUTHORITY
8005961862010-08-1123500000CONSTRUCTION OF NEW BUILDING000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceeds
2200000017227672500002200000020080011
220000002250002200000020080011
2350000093765812011100114123419

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000.000000.000000.000001
00000.000000.000000.000001
00000.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
100000
110000
000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2BARBARA DEPREE, A BOARD MEMBER AND EMPLOYEE, IS CHUCK DEPREE'S SISTER-IN-LAW. CHUCK DEPREE IS ALSO A BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE 990 IS PROVIDED TO CFO PRIOR TO CEO SIGNING.
THE BOARD OF DIRECTORS, ADMINISTRATION, DIRECTORS AND MANAGERS FILL OUT A CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. THESE FORMS ARE COLLECTED BY THE COMPLIANCE OFFICE, INVESTIGATED AND THEN MAINTAINED BY HUMAN RESOURCES. THE BYLAWS SPECIFICALLY STATE THAT A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST AS TO A MATTER BEFORE THE BOARD SHOULD NOT VOTE OR USE PERSONAL INFLUENCE WITH OTHER BOARD MEMBERS. THE MINUTES OF THE BOARD MEETING SHALL DISCLOSE THE MEMBER'S ABSITINENCE FROM VOTING ON THE MATTER.FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION USES CONSULTANTS TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM ANNUALLY AND RECOMMEND UPDATES/INCREASES AS DICTATED BY THE MARKET. COMPENSATION IS SET FOR EACH POSITION WITH ESTABLISHED TARGETS USING NATIONAL AND REGIONAL DATA FOR SIMILAR HOSPITALS. THIS POLICY IS BOARD APPROVED AND HAS AN ONGOING REVIEW PROCESS WHICH IS COMPARATIVE AND DATA-DRIVEN. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2011.FORM 990, PART VI, SECTION B, LINE 15
DOCUMENTS ARE AVAILABLE UPON REQUESTFORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 14,490,505. UNREALIZED GAIN/LOSS IN JOINT VENTURE TRANSFER TO AFFILIATEFORM 990, PART XI, LINE 5:
THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeBusiness Name Line1DirectControllingEntityName/BusinessNameLine1EOY AssetsEOYAssets
HH SERVICES LLC
602 MICHIGAN AVENUEHOLLANDMI49423208441842ENT PHYSICIAN OFFICEMI2027615HOLLAND COMMUNITY HOSPITAL
HH SERVICES -STAGEMAN LLC
602 MICHIGAN AVENUEHOLLANDMI49423260396174ENT PHYSICIAN OFFICEMI455974HOLLAND COMMUNITY HOSPITAL
HH SERVICES - BATES ET AL LLC
602 MICHIGAN AVENUEHOLLANDMI49423260396104UROLOOGY PHYSICIAN OFFICEMI-749776HOLLAND COMMUNITY HOSPITAL2129341
HH SERVICES - HOLLAND PROFESSIONAL SERVICES LLC
602 MICHIGAN AVENUEHOLLANDMI49423262764668WOMENS MIDLIFE PHYSICIAN OFFICEMI-59158HOLLAND COMMUNITY HOSPITAL-9305
HH SERVICES ORT LLC
602 MICHIGAN AVENUEHOLLANDMI49423264606759ORTHOPEDIC PHYSICIAN OFFICEMI-1462036HOLLAND COMMUNITY HOSPITAL238131
HOLLAND HOSPITAL PHYSISICAN CLINIC
602 MICHIGAN AVENUEHOLLANDMI49423263479537NOT ACTIVEMIHOLLAND COMMUNITY HOSPITAL
LAKESHORE HEALTH PARTNERS - FM LLC
602 MICHIGAN AVENUEHOLLANDMI49423272647439FAMILY MEDICINE PHYSICIAN OFFICEMI-1174624HOLLAND COMMUNITY HOSPITAL99975
HOLLAND SC LLC DBA SURGERY CENTER OF WEST MICHIGAN
602 MICHIGAN AVENUEHOLLANDMI49423203200415OUTPATIENT SURGERY CENTERMIHOLLAND COMMUNITY HOSPITAL

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HOLLAND COMMUNITY HEALTH CENTER
602 MICHIGAN AVENUEHOLLANDMI49423200602574HEALTHCAREMI501(C)(3)LINE 3SPECTRUM HEALTH MEDICAL GROUPS0
HOLLAND COMMUNITY HOSPITAL AUTHORITY SELF-INSURANCE TRUST FUND
602 MICHIGAN AVENUEHOLLANDMI49423386389385SUPPORTING ORGANIZATIONMI501(C)(3)LINE 11A, IHOLLAND COMMUNITY HOSPITAL1
HOLLAND COMMUNITY HOSPITAL AUXILIARY
602 MICHIGAN AVENUEHOLLANDMI49423382139025SUPPORTING ORGANIZATIONMI501(C)(3)LINE 11A, IHOLLAND COMMUNITY HOSPITAL1

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOLLAND COMMUNITY PHYSICIAN HOSPITAL ORGANIZATION
602 MICHIGAN AVENUEHOLLANDMI49423383268394PHYSICIAN SUPPORTMIC1099292899360.50000
LAKESHORE HEALTH PARTNERS
602 MICHIGAN AVENUEHOLLANDMI49423263518481ENDOSCOPY SERVICESMIC-169304414971501.00000HOLLAND COMMUNITY HOSPITAL
HH SERVICES - SOUTH WASHINGTON
602 MICHIGAN AVENUEHOLLANDMI49423270795175MEDICAL CLINICMIC-4450913089761.00000HOLLAND COMMUNITY HOSPITAL
LAKESHORE HEALTH PARTNERS FAMILY MEDICINE
602 MICHIGAN AVENUEHOLLANDMI49423271304003MEDICAL CLINICMIC2055581.00000HOLLAND COMMUNITY HOSPITAL
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 Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
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 (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LAKESHORE HEALTH PARTNERS
L1217000CONTRACTS AND TIME TRACKING
HOLLAND COMMUNITY HEALTH CENTER
I64015RENTAL AGREEMENT