THREE RIVERS HEALTH SYSTEM INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- THREE RIVERS HEALTH SYSTEM INC (EIN 38-2317300)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201243209349307649
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T16:13:24-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 TRADE CENTRE WAY STE 300 | AddressLine1 |
| City | PORTAGE | City |
| State | MI | State |
| ZIP Code | 49002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382317300 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | THRE | NameControl |
| Phone | 2692781145 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1 |
| City | THREE RIVERS | City |
| State | MI | State |
| ZIP Code | 49093 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVE ANDREWS | Name |
| Title | VICE PRESIDENT OF FINANCE | Title |
| Phone | 2692781145 | Phone |
| Date Signed | 2012-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CAROL LALONDE CPA | Name |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEVE ANDREWS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1 |
| City | THREE RIVERS | City |
| State | MI | State |
| ZIP Code | 49093 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 49480642 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.THREERIVERSHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1979 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 545 | TotalNbrEmployees |
| Total Nbr Volunteers | 80 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 24001 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 41182 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 42072301 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 49199549 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 32195 | InvestmentIncomePriorYear |
| Investment Income Current Year | 33883 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4402093 | OtherRevenuePriorYear |
| Other Revenue Current Year | 142166 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 46530590 | TotalRevenuePriorYear |
| Total Revenue Current Year | 49416780 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22269233 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22556189 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 23904509 | OtherExpensePriorYear |
| Other Expenses Current Year | 25929281 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 46173742 | TotalExpensesPriorYear |
| Total Expenses Current Year | 48485470 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 356848 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 931310 | RevenuesLessExpensesCY |
| Total Assets BOY | 22634960 | TotalAssetsBOY |
| Total Assets EOY | 21073896 | TotalAssetsEOY |
| Total Liabilities BOY | 13934152 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11441778 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8700808 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9632118 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE HOSPITAL'S MISSION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE TO OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 41354727 | Expense |
| Revenue | 49199549 | Revenue |
| Description | GENERAL ACUTE SERVICES FOR COMMUNITY INPATIENT AND OUTPATIENT SERVICES. | Description |
| Total Program Service Expense | 41354727 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 38 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 545 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVEN T ANDREWS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2692739604 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1 |
| City | THREE RIVERS | City |
| State | MI | State |
| ZIP Code | 49093 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| LAURIE HINES | |||||||
| VICE CHAIR | 3.00 | X | X | 0 | 0 | 0 | |
| KEN WIENCEK DO | |||||||
| CHIEF OF STAFF - NON-VOTING | 3.00 | X | X | 0 | 495130 | 24135 | |
| ANDY GOLDBERGER | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| DIANA DEGRAAF | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| PAT HENDERSON | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| LARRY HERMEN | |||||||
| SECRETARY | 3.00 | X | X | 0 | 0 | 0 | |
| GARRETT HALL | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| RAY BENDURE | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| JOHN TOUSE | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| LARRY CLARK | |||||||
| BOARD CHAIR | 3.00 | X | X | 0 | 0 | 0 | |
| JACKIE BOWEN | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| HENRI'ETTA TOLBERT | |||||||
| BOARD MEMBER | 3.00 | X | 0 | 0 | 0 | ||
| SUE POTTS | |||||||
| TREASURER | 3.00 | X | X | 0 | 0 | 0 | |
| WILLIAM RUSSELL | |||||||
| PRESIDENT/CEO | 40.00 | X | 225416 | 0 | 57528 | ||
| STEVE ANDREWS | |||||||
| VICE PRESIDENT | 40.00 | X | 159491 | 0 | 44051 | ||
| HOPE BAILEY | |||||||
| VICE PRESIDENT | 40.00 | X | 121128 | 0 | 25884 | ||
| ALICE MAYER | |||||||
| VICE PRESIDENT | 40.00 | X | 80569 | 0 | 26968 | ||
| MIKE PULFORD | |||||||
| CRNA | 40.00 | 145433 | 0 | 40593 | X | ||
| LEONARD DARLING | |||||||
| PHARMACY MANAGER | 40.00 | 123795 | 0 | 19788 | X | ||
| DOUG ZEHNER | |||||||
| PHARMACIST | 40.00 | 111560 | 0 | 20446 | X | ||
| DENNIS KNOLL | |||||||
| PHARMACIST | 40.00 | 112935 | 0 | 16190 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1080327 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 495130 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 275583 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BORGESS MEDICAL CENTER | |||||
| 1521 GULL ROAD | KALAMAZOO | MI | 49048 | LAB, LAUNDRY, IT SERVICES | 1246769 |
| QHR | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TN | 37027 | MANAGEMENT SERVICES, SALARIES | 840008 |
| REHABCARE GROUP | |||||
| PO BOX 502096 | ST LOUIS | MO | 63150 | REHAB MANAGEMENT | 317461 |
| OPTIMUM OUTCOMES | |||||
| 4524 SOUTHLAKE PKWY | HOOVER | AL | 35744 | PATIENT COLLECTION SERVICES | 304909 |
| ECLIPSE CAPITAL | |||||
| 2207 ORCHARD LAKE RD | SYLVAN LAKE | MI | 48320 | FINANCIAL CONSULTING | 205319 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 11 | NumberOfContractorsGT100K |
| All Other Contributions | 41182 | AllOtherContributions |
| Total Contributions | 41182 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | 43922815 | 43922815 |
| OTHER PROGRAM REVENUE | 621110 | 5276734 | 5276734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 49199549 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32973 | TotalRevenueColumn |
| Exclusion | $32,973 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 132747 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 63862 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 68885 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 68885 | TotalRevenueColumn |
| Exclusion | $68,885 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 910 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 910 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 910 | TotalRevenueColumn |
| Exclusion | $910 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA/VENDING | 900099 | 47571 | $47,571 |
| MISCELLANEOUS | 900099 | 25710 | $25,710 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 73281 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 49416780 | TotalRevenueColumn |
| Related Or Exempt Function Income | 49199549 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $176,049 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 770065 | Total |
| Management And General | 770065 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16504207 | Total |
| Program Services | 14071990 | ProgramServices |
| Management And General | 2432217 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 185419 | Total |
| Program Services | 166877 | ProgramServices |
| Management And General | 18542 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3762274 | Total |
| Program Services | 3386047 | ProgramServices |
| Management And General | 376227 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1334224 | Total |
| Program Services | 1200802 | ProgramServices |
| Management And General | 133422 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255622 | Total |
| Program Services | 255622 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194679 | Total |
| Program Services | 194679 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96126 | Total |
| Program Services | 96126 | ProgramServices |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4995 | Total |
| Management And General | 4995 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 139996 | Total |
| Program Services | 139996 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6979902 | Total |
| Program Services | 5152598 | ProgramServices |
| Management And General | 1827304 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18721 | Total |
| Program Services | 18721 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 272930 | Total |
| Management And General | 272930 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2242679 | Total |
| Program Services | 2242679 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174929 | Total |
| Program Services | 174929 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 317921 | Total |
| Program Services | 317921 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2574659 | Total |
| Program Services | 2574659 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 765432 | Total |
| Program Services | 54448 | ProgramServices |
| Management And General | 710984 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 5665906 | 5519709 | 146197 |
| PHYSICIAN FEES | 3947582 | 3947582 | |
| EQUIP RENTAL AND MAINT | 1824242 | 1421367 | 402875 |
| PROF DUES & DEVELOPMENT | 103110 | 103110 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 349850 | Total |
| Program Services | 314865 | ProgramServices |
| Management And General | 34985 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48485470 | Total |
| Program Services | 41354727 | ProgramServices |
| Management And General | 7130743 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 616145 | BOY |
| EOY | 499662 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5219411 | BOY |
| EOY | 5023368 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 574851 | BOY |
| EOY | 621088 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 821087 | BOY |
| EOY | 1138798 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 47808782 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 36219748 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13593905 | BOY |
| EOY | 11589034 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 891330 | BOY |
| EOY | 668392 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 918231 | BOY |
| EOY | 1533554 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22634960 | BOY |
| EOY | 21073896 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6641078 | BOY |
| EOY | 6133351 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3498747 | BOY |
| EOY | 201000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3463416 | BOY |
| EOY | 2037160 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2000000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 330911 | BOY |
| EOY | 1070267 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13934152 | BOY |
| EOY | 11441778 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8700808 | BOY |
| EOY | 9632118 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8700808 | BOY |
| EOY | 9632118 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22634960 | BOY |
| EOY | 21073896 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 931310 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $4,995 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4995 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | A PORTION OF MHA DUES IS ALLOCATED TO LOBBYING EXPENSE. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 219500 | OtherCostOrOtherBasis |
| Book Value | 219500 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20567204 | OtherCostOrOtherBasis |
| Depreciation | 13329905 | Depreciation |
| Book Value | 7237299 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27022078 | OtherCostOrOtherBasis |
| Depreciation | 22889843 | Depreciation |
| Book Value | 4132235 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11589034 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| COST REPORT SETTLEMENTS | 1523169 |
| BOND FEES NET OF AMORTIZATION | 10385 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1533554 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | COST REPORT SETTLEMENTS PAYABLE | Description |
| Amount | $1,070,267 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1070267 | TotalOfAmounts |
| Total Revenue | 49416780 | TotalRevenue |
| Total Expenses | 48485470 | TotalExpenses |
| Excess Or Deficit For Year | 931310 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 931310 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE HOSPITAL, TRAH PROPERTIES, AND THREE RIVERS HEALTH FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. IHS AND PHO ARE DEEMED A CORPORATIONS AND FILE 1120S WITH NO TAX DUE. THE HOSPITAL'S TAX RETURNS ARE NOT SUBJECT TO EXAMINATION BY TAXING AUTHORITIES FOR YEARS BEGINNING PRIOR TO DECEMBER 31, 2008. 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. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 250.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 280721 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 280721 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11881766 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7904275 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3977491 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08200 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1008648 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 232241 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 776407 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01600 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13171135 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8136516 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5034619 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10380 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 93798 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 93798 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 78712 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 78712 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2937794 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4004044 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1066250 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3110304 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4004044 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -893740 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16281439 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12140560 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4140879 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10730 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 88452 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 88452 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 88452 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 88452 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $8,451,890 | BadDebtExpenseAmount |
| Amount Attributable To | 752473 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 10647517 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12259097 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1611580 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 S HEALTH PARKWAY | AddressLine1 |
| City | THREE RIVERS | City |
| State | MI | State |
| ZIP Code | 49093 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THREE RIVERS HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 250.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 250.000000000000 | FPGDiscountPercent |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| THREE RIVERS HEALTH FAMILY CARE | ||||
| 677 E MAIN STREET PO BOX 310 | CENTREVILLE | MI | 49032 | RURAL HEALTH CLINIC - CENTREVILLE |
| THREE RIVERS HEALTH FAMILY CARE | ||||
| 721 6TH AVENUE STE B | THREE RIVERS | MI | 49093 | RURAL HEALTH CLINIC - THREE RIVERS |
| THREE RIVERS HEALTH FAMILY CARE | ||||
| 119 S KALAMAZOO STREET PO BOX 295 | CENTREVILLE | MI | 49032 | RURAL HEALTH CLINIC -WHITE PIGEON |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS INSTRUCTIONS. | ||
| PART II: WE CONTINUE TO INVEST IN PHYSICIAN RECRUITING INITIATIVES, TO ENSURE THAT WE HAVE ADEQUATE PROVIDERS TO MEET THE ACCESS NEED IN ST. JOE COUNTY. | ||
| PART III, LINE 4: THE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. RETROACTIVELY CALCULATED ADJUSTMENTS ARISING UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED.LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE COMPLEX AND SUBJECT TO INTERPRETATION. MANAGEMENT BELIEVES THAT IT IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. FINAL DETERMINATION OF COMPLIANCE OF SUCH LAWS AND REGULATIONS IS SUBJECT TO FUTURE GOVERNMENT REVIEW AND INTERPRETATION. VIOLATIONS MAY RESULT IN SIGNIFICANT REGULATORY ACTION INCLUDING FINES, PENALTIES, AND EXCLUSION FROM THE MEDICARE AND MEDICAID PROGRAMS.BAD DEBT EXPENSES IS TYPICALLY DOLLARS THAT ARE WRITTEN OFF OR RESERVED FOR THAT PERTAINS TO PATIENTS THAT HAD AVAILABLE RESOURCES, BUT WOULD NOT PAY FOR THEIR SERVICES. THE EXCEPTION TO THIS RULE APPLIES TO CHARITY CARE ACCOUNTS THAT ACTUALLY ARE INCLUDED IN BAD DEBT BECAUSE OF LACK OF INFORMATION PROVIDED, OR BECAUSE OF THE TIMING OF DETERMINTATION FOR CHARITY CARE. WE ESTIMATE THAT AT THE END OF 2011, APPROXIMATELY $1,000,000 DOLLARS INCLUDED IN BAD DEBT SHOULD ACTAULLY BE CONSIDERED CHARITY CARE. BECAUSE OF THIS WE BELIEVE THIS SHOULD ALSO BE INCLUDED IN OUR COMMUNITY BENEFIT CALCULATION. | ||
| PART III, LINE 8: THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MANY OF THESE PATIENTS HAVE LIMITED INCOME WHICH IN MOST CASES IS FIXED. THE COST TO CHARGE RATIO WAS USED TO DETERMINE COSTS. WITH MEDICARE BEING OUR LARGEST POPULATION OF PATIENTS, THE MEDICARE SHORTFALL IS ENORMOUS, THUS SHOULD BE TREATED AS A SIGNIFICANT COMMUNITY BENEFIT. | ||
| PART III, LINE 9B: THE HOSPITAL CURRENT COLLECTION PRACTICES APPLY TO ALL PATIENTS. IF NO INSURANCE IS AVAILABLE, AND THEY DO NOT QUALFY FOR CHARITY CARE, WE THEN MAKE THEM AWARE OF THEIR OPTIONS. DISCOUNTS ARE OFFERED, WHICH ARE BASED ON OUR DISCOUNTS GIVEN TO COMMERCIAL PAYORS. PAYMENT ARRANGEMENTS CAN BE MADE THAT COVER A SPECIFIC PERIOD OF TIME. ONCE ARRANGEMENTS ARE MADE, THE COLLECTION PROCESS FOLLOWS THE STANDARD OF COLLECTION NOTICES, AND PHONE CALLS. AFTER 120 DAYS, IF NO PAYMENT HAS BEEN MADE, OR IF PAYMENT ARRANGEMENTS ARE NOT KEPT, THE BALANCES WILL BE REFERRED TO A COLLECTION AGENCY. | ||
| PART V, SECTION B, LINE 21: ALL PATIENTS ARE BILLED THE INITIAL CHARGES, THUS, IF THEY QUALIFY FOR ASSISTANCE, THE FULL AMOUNT WILL BE WRITTEN OFF. FOR PATIENTS THAT HAVE NO INSURANCE BUT DO NOT QUALIFY FOR ASSISTANCE, SOME WILL STILL QUALIFY FOR DISCOUNTS BASED ON TIMING OF PAYMENT OR PAYMENT PLANS. | THREE RIVERS HEALTH | |
| PART VI, LINE 2: THE ORGANIZATION CURRENTLY REVIEWS THE HEALTH INDICATORS OF THE COUNTY, AND ALSO FROM TIME TO TIME COMPLETES COMMUNITY SURVEYS. WE ALSO DO PHYSICIAN DEMAND REVIEWS TO DETERMINE IF THERE ARE PHYSICIAN SHORTAGES IN OUR COMMUNITY. WE ALSO REVIEW BY SERVICE AND PATIENT TYPE, TO SEE IF THERE ARE ANY TRENDS THAT INDICATE CHANGES IN UTILIZATION AT THE HOSPITAL. WE ALSO PARTNER WITH THE SCHOOLS, AND COMMUNITY MENTAL HEALTH, TO IDENTIFY ANY INITIATIVES THAT WOULD BENEFIT THE COMMUNITY. WE ALSO HAVE AN EXTENSIVE PATIENT SATISFACTION PROGRAM THAT IDNETIFIES POTENTIAL GAPS IN COMMUNITY SERVICE. | ||
| PART VI, LINE 3: ONCE WE IDENTIFY A PATIENT WHO HAS NO COVERAGE, WE SEND THEM TO OUR PATIENT ASSISTANCE REPRESENATIVE. THIS REPRESENATIVE WILL THAN GO OVER ALL THE OPTIONS THAT ARE AVAILABLE FOR THAT INDIVIDUAL. IF MEDICAID IS A POSSIBILITY, WE THEN SEND THIS PERSON TO OUR MEDICAID SPECIALIST, WHO WILL HELP THEM WITH THE PROCESS,AS WELL AS ANY FORMS. WE HAVE A FORMAL CHARITY CARE PROGRAM, WHICH IS ADVERTISED HOSPITAL WIDE, AND ON OUR WEBSITE. IF THEY QUALIFY FOR CHARITY CARE, WE WILL EDUCATE THEM AS ASSIST THEM WITH THE PAPERWORK AND PROCESS. | ||
| PART VI, LINE 4: THE HOSPITAL PRESENTLY HELPS SERVE ST. JOE COUNTY ALONG WITH OTHER PROVIDERS IN THE COMMUNITY. THE POPULATION OF THIS COMMUNITY IS APPROXIMATELY 63,000. THE COMMUNITY IS PRESENTLY ECONOMICALLY DEPRESSED. IT WAS AN AREA THAT WAS HEAVILY DEPENDENT ON THE AUTO INDUSTRY. THE UNEMPLOYMENT RATE IS VERY HIGH, AND THE COUNTY HAS A VERY HIGH MEDICAID POPULATION. IN ADDITON, THE NUMBER OF PEOPLE WITHOUT HEALTH INSURANCE HAS ALSO INCREASED IN THE PAST FEW YEARS. IT IS CLASSIFIED AS A RURAL AREA IN THE MIDWEST, THOUGH IT IS CLOSE TO URBAN AREAS. | ||
| PART VI, LINE 5: THE HOSPITAL OWNS AND OPERATES A 32,000 SQUARE FOOT WELLNESS CENTER, WHICH PROVIDES MEMBERSHIP OPTIONS TO THE PUBLIC, HEALTH ASSESSMENTS, DIABETIC EDUCATION, DIET PLANS, OP PHYSICAL THERAPY, AND CARDIAC REHAB. THIS WELLNESS CENTER PROVIDES MEMBERSHIPS AT A REDUCED RATE, AND DOES NOT MAKE A PROFIT ON THE MEMBERSHIPS. WE PROMOTE HEALTH BY IMPROVING ACCESS TO CARE BY INVESTING IN THREE RURAL HEALTH CLINICS, WITH TWO OF THOSE CLINICS BEING OFF THE HOSPITAL CAMPUS. | ||
| MI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEN WIENCEK DO | |||||||||||||
| 0 | 489380 | 0 | 5750 | 0 | 0 | 0 | 0 | 0 | 24135 | 0 | 519265 | 0 | 0 |
| WILLIAM RUSSELL | |||||||||||||
| 213996 | 0 | 0 | 0 | 11420 | 0 | 0 | 0 | 57528 | 0 | 282944 | 0 | 0 | 0 |
| STEVE ANDREWS | |||||||||||||
| 148665 | 0 | 0 | 0 | 10826 | 0 | 3195 | 0 | 40856 | 0 | 203542 | 0 | 0 | 0 |
| MIKE PULFORD | |||||||||||||
| 142683 | 0 | 2750 | 0 | 0 | 0 | 20536 | 0 | 20057 | 0 | 186026 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION MISSION STATEMENT | FORM 990, PART I, LINE 1: | THE HOSPITAL'S MISSION IS TO PROVIDE ACCESS TO HIGH QUALITY HEALTHCARE TO OUR COMMUNITY. WE SERVE A COMMUNITY THAT HAS ONE OF THE HIGHEST UNEMPLOYMENT RATES IN THE STATE. WE EMPLOY 90% OF THE PHYSICIANS IN THE COMMUNITY, THUS PROVIDING ADEQUATE ACCESS TO OUR COMMUNITY, SPECIFICALLLY MEDICAID ELGIBLE PATIENTS. WE OPERATE 3 RURAL HEALTH CLINICS, AND WILL HAVE ONE MORE OPERATIONAL IN 2012, WHICH GREATLY ENHANCES ACCESS TO CARE. WE PROVIDE A FULL RANGE OF OB SERVICES TO THE COMMUNITY, OF WHICH OVER 60% IS MEDICAID. WE ALSO PROVIDE WELLNESS AND DIABETIC EDUCATION SERVICES TO THE COMMUNITY, AS WELL AS HOMECARE AND HOSPICE, ALL SERVICES THAT ARE HEAVILY SUBSIDIZED. IN ADDITION, THE HOSPITAL ALSO HAS A IP REHABILITATION UNIT ON CAMPUS AS WELL. WE HAVE STARTED AN EMPLOYEE WELLNESS PROGRAM INTERNALLY, AND PLAN TO WORK WITH LOCAL EMPLOYERS TO OFFER THIS SERVICE AS WELL. FUTURE PLANS INCLUDE OFFERING MENTAL HEALTH SERVICES, AND WOUND CARE SERVICES TO THE COMMUNITY. ADDITIONALLY, WE ARE ADDING RESOURCES TO HELP THE UNINSURED NAVIGATE THE REQUIREMENTS FOR OBTAINING INSURANCE COVERAGE FOR THEIR PROBLEMS. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL USES A MANAGEMENT COMPANY TO MANAGE OPERATIONS. THEY ALSO EMPLOY THE CEO AND CFO. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PRESENTED AT THE BOARD MEETING, AND REVIEWED BY OFFICERS AND MEMBERS DURING THE MEETING AFTER THE RETURN IS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE OFFICE REQUIRES ANNUAL DISCLOSURE, AND COMMUNICATES TO BOARD PERIODICALLY. IF A CONFLICT OF INTEREST ARISES, THE INDIVIDUAL IS REQUIRED TO LEAVE THE ROOM WHEN DISCUSSIONS TAKE PLACE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL USES DATA FROM MHA TO DETERMINE THE SALARY STRUCTURE FOR EMPLOYEES. FOR THE CEO AND CFO, QHR IS THE PRIMARY SOURCE FOR COMPENSATION, WHICH MUST BE APPROVED BY THE BOARD. THE SALARY PLAN IS PRESENTED TO THE FINANCE COMMITTEE AS WELL. ALL DECISIONS ARE DOCUMENTED IN THE BOARD MINUTES. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2011. | |
| FORM 990, PART VI, SECTION C, LINE 19 | POLICIES AND STATEMENTS ARE REVIEWED AT BOARD MEETINGS. THE LOCAL PRESS ALSO RECEIVES THIS INFORMATION. IF ADDITIONAL REQUESTS ARE MADE, THIS INFORMATION IS PROVIDED AS REQUESTED. | |
| FORM 990, PART VII: | STEVE ANDREWS AND WILLIAM RUSSELL EACH WORKED AN AVERAGE OF AT LEAST 6 HOURS PER WEEK AT RELATED ORGANIZATIONS. HOPE BAILEY WORKED AN AVERAGE OF AT LEAST 5 HOURS PER WEEK AT A RELATED ORGANIZATION. LARRY CLARK AND PAT HENDERSON EACH WORKED AN AVERAGE OF AT LEAST 1 HOUR AT A RELATED ORGANIZATION. KEN WIENCEK, DO WORKED AN AVERAGE OF AT LEAST 40 HOURS PER WEEK AT A RELATED ORGANIZATION. | |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| THREE RIVERS HEALTH FOUNDATION | ||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 201384776 | FOUNDATION TO HOSPITAL | MI | 501(C)(3) | 11 TYPE 1 | THREE RIVERS HEALTH AUTHORITY | 1 |
| TRAH PROPERTIES INC | ||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383366344 | PROPERTY MANAGEMENT | MI | 501(C)(3) | 11 TYPE 1 | THREE RIVERS HEALTH AUTHORITY | 1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THREE RIVERS HEALTH NETWORK | |||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383330974 | MEDICAL DATA PROCESSING | MI | THREE RIVERS HEALTH AUTHORITY | C | 13840 | 1.00000 | |
| INTEGRATED HEALTH SYSTEMS INC | |||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383134384 | PERSONNEL MANAGEMENT | MI | C | N/A | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| TRAH PROPERTIES INC | ||
| J | 309139 | RENT PAID |
| INTEGRATED HEATH SYSTEMS INC | ||
| O | 4333547 | FMV |
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