2011-02-14T13:12:30-06:00 2010-03-31 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2009-04-01 208756459 MACKINAC STRAITS HEALTH SYSTEM INC MACK 9066438585 220 BURDETTE STREET ST IGNACE MI 49781 JASON ANDERSON 9066438585 2011-02-14 1 Terri Rexrode CPA MST 9206620016 2011-02-14 2009 2016-02-24 21:20:13Z JASON ANDERSON 220 BURDETTE STREET ST IGNACE MI 49781 23152731 0 X www.macinacstraitshealth.org X 2008 MI WE WILL BE THE HOSPITAL OF CHOICE AND RECOGNIZED FOR OUR EXEMPLARY PATIENT CARE, PEOPLE AND PERFORMANCE. WE HAVE A PASSION FOR EXCELLENCE AND STRIVE TO SET AND DELIVER THE HIGHEST STANDARDS OF SERVICE, INTEGRITY AND MOST OF ALL QUALITY. WE VALUE THE DIVERSITY AND CULTURES IN OUR COMMUNITY. 7 7 276 55 0 0 625604 206932 14582899 22745905 6485 746 842315 137828 16057303 23091411 0 0 9662306 13970032 0 32135 6153637 9385324 15815943 23355356 241360 -263945 40897659 47822221 40557214 46832945 340445 989276 PROVIDING LOCAL ACCESS AND QUALITY HEALTHCARE TO THE FAMILIES AND COMMUNITIES WE SERVE. 0 0 21492279 21831791 MACKINAC STRAITS HEALTH SYSTEM, INC. OPERATES A 15-BED ACUTE CARE FACILITY, A 48-BED LONG-TERM CARE UNIT, AND SEVERAL PHYSICIAN CLINICS IN MACKINAC COUNTY, MICHIGAN. THEY PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, AND PHYSICIAN SERVICES TO THE RESIDENTS OF MACKINAC COUNTY AND THE SURROUNDING AREAS. 21492279 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 303 0 1 276 1 0 0 0 0 0 0 0 0 0 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 1 1 0 X JASON ANDERSON 9066438585 220 BURDETTE STREET ST IGNACE MI 49781 Ronald Mitchell 1.00 X 0 0 0 Fred Paquin 1.00 X 0 0 0 Margaret Doud 1.00 X 0 0 0 Richard Smith 1.00 X 0 0 0 Walter North 1.00 X 0 0 0 Patrick Shannon 1.00 X 0 0 0 Steve Autore 1.00 X 0 0 0 RODNEY NELSON 40.00 X 125843 0 20861 JASON ANDERSON 40.00 X 66189 0 15223 JOHN STEPHENSON 40.00 X 188790 0 0 JONATHAN SCHUMAKER 40.00 X 309762 0 15223 EDWARD SMITH 40.00 X 166517 0 0 ALICE LINDSEY 40.00 X 128077 0 5638 KAREN MILJOUR 40.00 X 161600 0 12686 CAROL HAWKINS 40.00 X 147799 0 18323 1294577 0 87954 7 0 1 0 0 15197 73069 118666 206932 Patient Revenue 900099 20764634 20764634 Tax Levy Revenue 900099 1067157 1067157 Other Revenue 900099 914114 914114 22745905 746 746 118181 118181 118181 118181 79848 15197 61320 18528 18528 1119 1119 1119 23091411 21831791 0 1052688 416906 188790 228116 9522221 8960352 561869 1194458 1098901 95557 2082488 2073995 8493 753959 693642 60317 49032 49032 276087 276087 2019190 1840630 178560 98409 98409 3206083 3195497 10586 814695 808002 6693 109431 88677 20754 13182 12583 599 269299 269299 506153 506153 176052 176052 Bad Debt Expense 929685 929685 QAAP Taxes Paid 629804 629804 Miscellaneous 234969 176915 25919 32135 Dues and Subscriptions 53253 49578 3675 23355356 21492279 1830942 32135 440443 21477 159131 214586 2582264 2903877 251000 292459 238960 255728 120070 150255 41933602 7178868 15240437 34754734 21865354 9229105 40897659 47822221 4495519 5553403 1000000 1000000 27985000 27805000 4104216 10400000 2972479 2074542 40557214 46832945 X 0 0 0 0 340445 989276 340445 989276 40897659 47822221 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1094 1094 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: The organization belongs to the MHA and pays dues of $7,387. 14.81% or $1,094 of the dues are spent on lobbying purposes. 1213406 1213406 10140469 4151977 5988492 29859 29859 0 3203775 2997032 206743 27346093 27346093 34754734 Unamortized Debt Issue Costs 1956895 Receivable from Mackinac Island Health Center 364278 Other Assets 1149394 Construction fund 2708695 Debt service reserve 1465687 restricted investments 242334 Capitalized interest 614006 DUE FROM THIRD PARTY PAYORS 727816 9229105 Pension Liability 1904515 Patient Trust Savings 20027 Line of Credit 150000 2074542 23091411 23355356 -263945 -9773 922549 912776 648831 23152731 0 23152731 -61320 -61320 23091411 23416676 61320 61320 23355356 0 23355356 Part X: Description of Uncertain Tax Positions Under FIN 48: THERE IS NO FOOTNOTE REGARDING THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. Part XI, Line 8 - Other Adjustments: Change in pension obligation: 922549. Part XII, Line 4b - Other Adjustments: FUNDRAISING EXPENSES: -61320. Part XIII, Line 2d - Other Adjustments: FUNDRAISING EXPENSES: 61320. GOLF TOURNAMENT-2009 80788 1000 79788 2608 1000 48996 4028 HOPING FOR A CURE-2009 14257 14197 60 4688 95045 15197 79848 2608 1000 48996 8716 61320 18528 1 1 1 X 1 X 150.000000000000 1 0 0 1 1 724800 724800 0.03230 4613153 3687047 926106 0.04130 5337953 3687047 1650906 0.07360 14771 14771 2000 2000 0.00010 4450 4450 0.00020 21221 14771 6450 0.00030 5359174 3701818 1657356 0.07390 0 921129 904812 5212417 6107710 -895293 X 0 Mackinac Straits Health System Inc

220 Burdette Street St Ignace MI 49781

X X RHC Mackinac Island Medical Clinic

7474 Market Street Mackinac Island MI 49757

X Part I, Line 7: THE ORGANIZATION UTILIZES A COST TO CHARGE RATIO WHEN CALCULATING THE PERCENTAGE OF CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES. Part I, Line 7f: THE BAD DEBT EXPENSE IS CALCULATED UTILIZING ACTUAL WRITE-OFFS AND THE AMOUNTS THAT HAVE BEEN DETERMINED LIKELY TO BE WRITTEN OFF GIVEN PAST EXPERIENCE OF THE COLLECTION POSSIBILITIES.THERE IS NOT A FINANCIAL STATEMENT FOOTNOTE ON BAD DEBT EXPENSE. Part III, Line 8: Medicare allowable costs are from the Medicare cost report SCHEDULE H, PART i, LINE 7, COLUMN (F): THE DENOMINATOR WAS REDUCED BY THE BAD DEBT EXPENSE OF $921,129. Part VI, Line 2: Feedback from community members via survey and presentations at local organizations Part VI, Line 3: Pamplets and other literature and signage Part VI, Line 4: Mackinac County - a rural county in Michigan's Upper Penninsula. Seasonal economy with higher than average unemployment. Aging population with large number of Native Americans. Part VI, Line 5: Provided 24 hour emergency and essential health care services to rural community. Part VI, Line 6: A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND ALSO PROVIDES COURTESY PRIVILIGES TO AMNY VISITING SPECIALISTS WHO ARE ALSO PROVIDED SPACE IN OUR BUILDINGS IN ORDER TO SEE THEIR PATIENTS. Part VI, Line 7: N/A X X 0 0 0 0 0 0 0 0 0 JOHN STEPHENSON 188790 0 0 0 0 0 0 0 0 0 188790 0 0 0 JONATHAN SCHUMAKER 309762 0 0 0 0 0 0 0 15223 0 324985 0 0 0 EDWARD SMITH 165750 0 0 0 767 0 0 0 0 0 166517 0 0 0 KAREN MILJOUR 161600 0 0 0 0 0 0 0 12686 0 174286 0 0 0 CAROL HAWKINS 147500 0 0 0 299 0 0 0 18323 0 166122 0 0 0 Mackinac Straits Health System Inc 208756459 NONEAVAIL 2008-09-03 24120000 Construct a new hospital and health care facility 0 0 Mackinac Straits Health System Inc 208756459 NONEAVAIL 2008-09-03 2680000 Construct a new hospital and health care facility 0 0 24120000 4342093 1979910 17797997 2010 1 0 1 1 2680000 511247 219990 1948763 2010 1 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 TRANSAMERICA LIFE INSURANCE COMPANY 1.833333300000 1 0 1 0 0 0 1 TRANSAMERICA LIFE INSURANCE COMPANY 1.833333300000 1 0 1 Form 990, Part VI, Section B, line 11 The 990 return is e-mailed to the board members prior to filing with the IRS. Form 990, Part VI, Section B, line 15 THE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. THE COMPENSATION IS THEN REVIEWED BY THE BOARD FOR THE CEO AND IS REVIEWED BY THE CEO FOR OTHER OFFICERS AND KEY EMPLOYEES. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES THEIR DOCUMENTATION AVAILABLE TO THE PUBLIC BY REQUEST ONLY. Form 990, Part XI, Line 2c Oversight of audit Presented to the Finance Committee and recommendations taken to the Board of Directors