COREWELL HEALTH: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-1360562)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-05-12
- IRS object ID
- 201121329349302642
- Schema version
- 2009v1.7
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-12T13:29:15-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
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 | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381360562 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PENN | NameControl |
| Phone | 2699453451 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 WEST GREEN STREET | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Connie S Downs | Name |
| Title | Chief Financial Officer | Title |
| Phone | 2699453451 | Phone |
| Date Signed | 2011-05-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carol LaLonde CPA | Name |
| Phone | 2695674500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | 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 | PENNOCK HEALTH SYSTEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Connie S Downs | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 WEST GREEN STREET | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 80642570 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.PENNOCKHEALTH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1923 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | THE HOSPITAL'S MOST SIGNIFICANT ROLE IS TO PROVIDE HEALTHCARE SERVICES TO THE CITIZENS OF BARRY COUNTY. ALL ACTIVITIES ASSOCIATED WITH THIS PURPOSE ARE INCLUDED IN THE DETERMINATION OF THE OPERATING INCOME. NET ASSETS OF THE HOSPITAL ARE GENERALLY UNRESTRICTED AND ARE AVAILABLE FOR THE DELIVERY OF HEALTHCARE SERVICES, WITH THE EXCEPTION OF CONTRIBUTIONS FROM INDIVIDUAL DONORS, WHICH ARE TEMPORARILY RESTRICTED FOR THE PURPOSE INTENDED BY THE DONOR. PENNOCK TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 665 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 404599 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -6854 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 99451 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 55983 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 52991852 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 54409950 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4077397 | InvestmentIncomePriorYear |
| Investment Income Current Year | 964594 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 509638 | OtherRevenuePriorYear |
| Other Revenue Current Year | 472714 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 57678338 | TotalRevenuePriorYear |
| Total Revenue Current Year | 55903241 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 27616083 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 27325922 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 26512469 | OtherExpensePriorYear |
| Other Expenses Current Year | 27226850 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 54128552 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54552772 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3549786 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1350469 | RevenuesLessExpensesCY |
| Total Assets BOY | 79524235 | TotalAssetsBOY |
| Total Assets EOY | 80558605 | TotalAssetsEOY |
| Total Liabilities BOY | 13419765 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10862743 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 66104470 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 69695862 | NetAssetsOrFundBalancesEOY |
| Mission Description | PENNOCK HOSPITAL'S MISSION IS TO PROVIDE QUALITY HEALTH SERVICES IN A PERSONAL, PROFESSIONAL AND PROGRESSIVE MANNER IN PARTNERSHIP WITH THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 39544324 | Expense |
| Revenue | 54409950 | Revenue |
| Description | PENNOCK CONTINUED TO DEMONSTRATE VALUE DURING 2010 THROUGH THE EXTENSION OF SERVICES TO OUR OUTLYING MARKETS. THE FACILITIES PROVIDED OUR PATIENTS WITH EASIER ACCESS TO ROUTINE SERVICES SUCH AS LAB, RADIOLOGY, ORTHOPEDICS, SURGERY CONSULTATION, OCCUPATIONAL MEDICINE, REHABILITATION, AND FAMILY MEDICINE. PENNOCKS COMMITMENT TO PROVIDE QUALITY HEALTH CARE CONTINUES TO BE THE OVERARCHING THEME. AS SUCH, INVESTMENTS IN FACILITIES, TECHNOLOGY AND MEDICAL STAFF CONTINUE TO BETTER SERVE OUR COMMUNITY.ADULT AND PEDIATRIC ADMISSION 2,794AVERAGE DAILY CENSUS 29AVERAGE LENGTH OF STAY (DAYS) 4BIRTHS (NUMBER OF DELIVERIES) 356CARDIOPULMONARY TREATMENTS 43,566DIETARY (MEALS SERVED) 186,416EMERGENCY ROOM VISITS 19,916EMPLOYEES 596HOMECARE VISITS 9,359LABORATORY PROCEDURES 318,661 PHARMACY (DOSES DISPENSED) 413,693RADIOLOGY (ALL PROCEDURES) 52,134 REHABILITATION SERVICES 36,453SURGICAL PROCEDURES 3,210URGENT CARE VISITS 13,697OCCUPATIONAL THERAPY 10,682PENNOCK TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. | Description |
| Total Program Service Expense | 39544324 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 41 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 665 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | 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 | 1 | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | connie downs | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2699483122 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 W GREEN ST | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Bonnie Hildreth | |||||||
| Member | 0.50 | X | 0 | 0 | 0 | ||
| Scott Brasseur MD | |||||||
| Secretary | 0.50 | X | 81052 | 0 | 0 | X | |
| Drew Chapple | |||||||
| Member | 0.50 | X | 0 | 0 | 0 | ||
| Maggie Coleman | |||||||
| Vice Chair | 0.50 | X | 0 | 0 | 0 | X | |
| Bruce Gee | |||||||
| Chairman | 0.50 | X | 0 | 0 | 0 | X | |
| Nancy Goodin | |||||||
| Member | 0.50 | X | 0 | 0 | 0 | ||
| Al Jarvis | |||||||
| Member | 0.50 | X | 0 | 0 | 0 | ||
| Bradley Johnson CPA | |||||||
| Member | 0.50 | X | 0 | 0 | 0 | ||
| John Walker | |||||||
| Treasurer | 0.50 | X | 0 | 0 | 0 | X | |
| David Baum | |||||||
| Member | 0.50 | X | 0 | 0 | 0 | ||
| KIMBERLY NORRIS MD | |||||||
| EX-OFFICIO VOTING MEMBER | 0.50 | X | 0 | 0 | 0 | X | |
| DAVID PARKER MD | |||||||
| EX- OFFICIO NON-VOTING MEMBER | 1.00 | X | 66504 | 0 | 0 | X | |
| Sheryl Lewis Blake | |||||||
| CEO | 40.00 | 262670 | 0 | 42203 | X | ||
| Connie S Downs | |||||||
| CFO | 40.00 | 186895 | 0 | 29932 | X | ||
| Carla Wilson-Neil | |||||||
| COO | 40.00 | 163864 | 0 | 35354 | X | ||
| ROSEANNE WOODLIFF | |||||||
| CHIEF NURSING OFFICER | 40.00 | 118550 | 0 | 1312 | X | ||
| James J Wincek | |||||||
| Vice President Support Ser | 40.00 | 119366 | 0 | 27008 | X | ||
| DONALD GINGRICH | |||||||
| Physician | 40.00 | 121135 | 0 | 9279 | X | ||
| Lawerence Hawkins | |||||||
| Physician | 40.00 | 133125 | 0 | 3752 | X | ||
| Craig Jones | |||||||
| Pharmacist | 40.00 | 113179 | 0 | 24591 | X | ||
| ANITA ASADORIAN MD | |||||||
| PHYsician | 40.00 | 140294 | 0 | 3108 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1506634 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 176539 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | 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 |
|---|---|---|---|---|---|
| Johnson Contruction | |||||
| 2442 28th street southwest | WYOMING | MI | 49519 | Construction | 1120365 |
| PROGRESSIVE BUILDING SERVICES | |||||
| 440 36th street | wyOMING | MI | 49548 | HOUSEKEEPING SERVICES | 778758 |
| Hastings Anesthesia PLC | |||||
| 900 Peeler St | Kalamazoo | MI | 49008 | Anesthesia Services | 686812 |
| Hastings Emergency Physicians | |||||
| PO Box 232 | Grand Rapids | MI | 49501 | ER Management | 482795 |
| Spectrum Health | |||||
| 4600 Breton Road SE | Kentwood | MI | 49508 | Reference Lab/Sleep Study | 308986 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Related Organizations | 49463 | RelatedOrganizations |
| All Other Contributions | 6520 | AllOtherContributions |
| Total Contributions | 55983 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Service Revenu | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 54409950 | TotalRevenueColumn |
| Related Or Exempt Function Income | 54409950 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 54409950 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 254364 | TotalRevenueColumn |
| Exclusion | $254,364 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 610374 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 849236 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -238862 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -238862 | TotalRevenueColumn |
| Exclusion | -$238,862 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 24600323 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 23890093 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 710230 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 710230 | TotalRevenueColumn |
| Exclusion | $710,230 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| Lab Courier Service | 621500 | 404599 | 404599 | |
| Cafeteria Revenue | 722100 | 259986 | $259,986 | |
| Miscellaneous | 900099 | 46991 | $46,991 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 711576 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55903241 | TotalRevenueColumn |
| Related Or Exempt Function Income | 54409950 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 404599 | UnrelatedBusinessRevenue |
| Exclusion | $1,032,709 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 815211 | Total |
| Program Services | 737787 | ProgramServices |
| Management And General | 77424 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20100238 | Total |
| Program Services | 12884325 | ProgramServices |
| Management And General | 7215913 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 969104 | Total |
| Program Services | 678373 | ProgramServices |
| Management And General | 290731 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3957398 | Total |
| Program Services | 2748483 | ProgramServices |
| Management And General | 1208915 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1483971 | Total |
| Program Services | 1038780 | ProgramServices |
| Management And General | 445191 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100944 | Total |
| Program Services | 25236 | ProgramServices |
| Management And General | 75708 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159419 | Total |
| Program Services | 90609 | ProgramServices |
| Management And General | 68810 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119252 | Total |
| Management And General | 119252 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7569320 | Total |
| Program Services | 4389912 | ProgramServices |
| Management And General | 3179408 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155024 | Total |
| Program Services | 38756 | ProgramServices |
| Management And General | 116268 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 945016 | Total |
| Program Services | 807784 | ProgramServices |
| Management And General | 137232 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1530158 | Total |
| Program Services | 1169928 | ProgramServices |
| Management And General | 360230 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253460 | Total |
| Program Services | 164749 | ProgramServices |
| Management And General | 88711 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132148 | Total |
| Program Services | 132148 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3698786 | Total |
| Program Services | 3143968 | ProgramServices |
| Management And General | 554818 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 287691 | Total |
| Program Services | 186999 | ProgramServices |
| Management And General | 100692 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 7111392 | 6580930 | 530462 |
| Bad Debts | 4241304 | 4241304 | |
| Maintenance and Repairs | 612163 | 484253 | 127910 |
| collections | 305971 | 305971 | |
| michigan business tax | 4802 | 4802 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54552772 | Total |
| Program Services | 39544324 | ProgramServices |
| Management And General | 15008448 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 662803 | BOY |
| EOY | 1118844 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6987967 | BOY |
| EOY | 5256826 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6932774 | BOY |
| EOY | 5878283 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5394935 | BOY |
| EOY | 5196061 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 682707 | BOY |
| EOY | 637299 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 779977 | BOY |
| EOY | 625542 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 72535892 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 49641277 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23670518 | BOY |
| EOY | 22894615 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26931276 | BOY |
| EOY | 38075963 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6612626 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 868652 | BOY |
| EOY | 875172 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79524235 | BOY |
| EOY | 80558605 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5065713 | BOY |
| EOY | 3897422 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6979453 | BOY |
| EOY | 5282877 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1374599 | BOY |
| EOY | 1682444 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13419765 | BOY |
| EOY | 10862743 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65272818 | BOY |
| EOY | 68857690 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 831652 | BOY |
| EOY | 838172 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66104470 | BOY |
| EOY | 69695862 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79524235 | BOY |
| EOY | 80558605 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3341127 | OtherCostOrOtherBasis |
| Book Value | 3341127 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 39155673 | OtherCostOrOtherBasis |
| Depreciation | 28150957 | Depreciation |
| Book Value | 11004716 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2317814 | OtherCostOrOtherBasis |
| Depreciation | 1259179 | Depreciation |
| Book Value | 1058635 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26536745 | OtherCostOrOtherBasis |
| Depreciation | 20231141 | Depreciation |
| Book Value | 6305604 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1184533 | OtherCostOrOtherBasis |
| Book Value | 1184533 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22894615 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Third Party Contractuals | Description |
| Amount | $1,682,444 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1682444 | TotalOfAmounts |
| Total Revenue | 55903241 | TotalRevenue |
| Total Expenses | 54552772 | TotalExpenses |
| Excess Or Deficit For Year | 1350469 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2240923 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 2240923 | TotalAdjustments |
| Excess Or Deficit Per FS | 3591392 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 58024912 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2240923 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 2240923 | RevenueNotRptdF990 |
| Revenue Subtotal | 55783989 | RevenueSubtotal |
| Investment Expenses Not Included | 119252 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 119252 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 55903241 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 54433520 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 54433520 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 119252 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 119252 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 54552772 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| 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 | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 187796 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 187796 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6616987 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5953604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 663383 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01220 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1294830 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 745072 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 549758 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01010 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8099613 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6698676 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1400937 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02570 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 83797 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21387 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 62410 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46762 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 46762 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31757 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 31757 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 162316 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21387 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 140929 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8261929 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6720063 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1541866 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02830 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 178545 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 178545 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2592 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2592 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 172 | PersonsServed |
| Total Community Building Expense | 3632 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3632 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2643 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2643 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 175 | NumberOfActivitiesOrPrograms |
| Persons Served | 3751 | PersonsServed |
| Total Community Building Expense | 48263 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 48263 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 16 | PersonsServed |
| Total Community Building Expense | 30072 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 30072 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 688 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 688 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 192 | NumberOfActivitiesOrPrograms |
| Persons Served | 3939 | PersonsServed |
| Total Community Building Expense | 266435 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 266435 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00490 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,702,035 | BadDebtExpenseAmount |
| Amount Attributable To | 189999 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12526868 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12350153 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 176715 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARRY HEALTH PARTNERS LTD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | TO INEGRATE PHYSICIAN AND HOSPITAL CLINICAL PRACTICES AND PAYOR CONTRACTING | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.50000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.50000 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV (10 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | OtherOther |
|---|---|---|---|---|---|---|
| PENNOCK HOSPITAL | ||||||
| 1009 W GREEN ST | HASTINGS | MI | 49058 | X | X | |
| PENNOCK HOSPICE | ||||||
| 1230 W STATE STREET | HASTINGS | MI | 49058 | OUTPATIENT HOSPICE CARE | ||
| PENNOCK HOME HEALTH | ||||||
| 1230 W STATE STREET | HASTINGS | MI | 49058 | HOME HEALTH CARE AGENCY | ||
| CLARKSVILLE FAMILY MEDICINE | ||||||
| 155 E CROSS ST | CLARKSVILLE | MI | 48815 | FAMILY PRACTICE OFFICE | ||
| NASHVILLE FAMILY MEDICINE | ||||||
| 750 DURKEE | NASHVILLE | MI | 49073 | FAMILY PRACTICE OFFICE | ||
| DR DEGOA | ||||||
| 1108 W STATE STREET | HASTINGS | MI | 49058 | OBSTETRICIAN | ||
| GUN LAKE FAMILY MEDICINE | ||||||
| 77 124TH AVE | SHELBYVILLE | MI | 49344 | FAMILY PRACTICE OFFICE | ||
| CALEDONIA FAMILY MEDICINE | ||||||
| 9090 RODGERS CT | CALEDONIA | MI | 49316 | FAMILY PRACTICE OFFICE | ||
| HASTINGS FAMILY MEDICINE | ||||||
| 1009 W GREEN ST | HASTINGS | MI | 49058 | FAMILY PRACTICE OFFICE | ||
| STATE STREET URGENT CARE CENTER | ||||||
| 1108 W STATE STREET | HASTINGS | MI | 49058 | URGENT CARE CENTER | ||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: COST TO CHARGE RATIO WAS USED TO DETERMINE PATIENT SERVICE COSTS. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: THE COST TO CHARGE RATIO WAS USED TO DETERMINE BAD DEBT AT COST REPORTED ON LINE 2. THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING THE BARRY COUNTY HEALTH PLAN CHARGES. THE CRITERIA USED FOR DETERMINING PATIENT ELIGIBILITY UNDER THE BARRY COUNTY HEALTH PLAN FALLS WITHIN OUR CHARITY CARE POLICY. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: PENNOCK HOSPITAL DOES NOT EXPERIENCE A MEDICARE SHORTFALL. THE MEDICARE COST REPORT WAS USED TO REPORT MEDICARE ALLOWABLE COSTS. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: IT IS THE POLICY OF PENNOCK HOSPITAL TO ACKNOWLEDGE AND UNDERSTAND THAT ALL ITS PATIENTS ARE NOT EQUALLY CAPABLE OF WITHSTANDING THE BURDEN OF PAYMENT FOR SERVICES, EITHER BY THEMSELVES OR THROUGH A THIRD PARTY INSURANCE CARRIER. ONCE THE DECISION IS MADE TO PROVIDE FINANCIAL ASSISTANCE, THE PATIENT IS NOTIFIED IN WRITING AND THE FINANCIAL COUNSELOR/CUSTOMER SERVICE REPRESENTATIVE ADJUSTS THE PATIENT'S OUTSTANDING BILL(S). UNEXPECTED SERVICES RENDERED AFTER A PRELIMINARY WRITE-OFF AND WITHIN NINETY DAYS OF A FINANCIAL REVIEW, WILL BE TREATED AS PART OF THE INITIAL AMOUNT AND ADJUSTED. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: PENNOCK HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE UTILIZING INTERNAL DATA, DATA COLLECTED FROM THOMPSON REUTERS, MICHIGAN HEALTH AND HOSPITAL ASSOCIATION, BARRY EATON HEALTH DEPARTMENT, LOCAL SOCIAL SERVICE AGENCIES, SCHOOL SYSTEMS, NATIONAL HEALTH ASSOCIATIONS (AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES), AND OUR PAYORS. THOMPSON REUTERS PROVIDES DATA REGARDING THE SERVICES BEING USED BY THE POPULATION WITHIN THE SERVICE AREA SUPPORTED BY PENNOCK HOSPITAL, INCLUDING PROJECTED POPULATION GROWTH TRENDS BY AGE AND SEX. THIS HELPS US TO EXAMINE THE PATIENT NEEDS AT A CLOSER LEVEL. LOCAL SOCIAL SERVICES AGENCIES AND SCHOOL SYSTEMS HELP US IDENTIFY SOCIOECONOMIC FACTORS CONTRIBUTING TO THE IDENTIFIED HEALTH STATUS OF OUR SERVICE AREA. THE NATIONAL HEALTH ASSOCIATIONS PROVIDE DATA AS RELATED TO THEIR DISEASE SPECIFIC AREA FOR OUR COUNTY. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: FOR SCHEDULED PATIENTS, DURING THE PRE-REGISTRATION PROCESS, STAFF MAY CONTACT PATIENTS TO DISCUSS THEIR PATIENT FINANCIAL RESPONSIBILITY, AND AT THAT TIME WILL DISCUSS ASSISTANCE, AND PAYMENT OPTIONS. FOR NON-SCHEDULED PATIENTS WHO ARE ADMITTED, OUR FINANCIAL COUNSELOR/CUSTOMER SERVICE REPRESENTATIVE WILL MEET WITH THE PATIENT. WE PROVIDE EDUCATION REGARDING GOVERNMENT-FUNDED PROGRAMS, INCLUDING MEDICARE AND MEDICAID, WITH ELIGIBILITY SPECIALISTS ON STAFF. WE ALSO WORK CLOSELY WITH COUNTY HEALTH PLAN STAFF TO IDENTIFY ELIGIBLE PATIENTS FOR SERVICES BEYOND THOSE PROVIDED AT PENNOCK HOSPITAL. WE ALSO EDUCATE OUR PATIENTS WITH ALL AVAILABLE PROGRAMS SPONSORED BY PENNOCK HOSPITAL, INCLUDING THE CHARITY POLICY, EXTENSION OF CREDIT THROUGH THE PENNOCK CREDIT PROGRAM OR THE HELP PROGRAM WHICH PROVIDES SHORT-TERM AND LONGER-TERM FINANCING OPTIONS. OPTIONS THAT ARE AVAILABLE ARE INCLUDED ON PRINTED MATERIALS WHICH ARE LOCATED THROUGHOUT THE COMMUNITY AT MANY FAMILY PRACTICE PHYSICIAN OFFICES AS WELL AS AROUND THE HOSPITAL CAMPUS. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: BARRY COUNTY, MICHIGAN IS THE COMMUNITY PENNOCK SERVES. BARRY COUNTY BOASTS 58,434 RESIDENTS, UP 3% SINCE 2000. WITH 13.7% OF THE POPULATION OVER THE AGE OF 65, BARRY COUNTY IS A RELATIVELY YOUNG COMMUNITY. BARRY COUNTY ALSO SERVES AS A STABLE COMMUTER COMMUNITY WHERE THE AVERAGE TRAVEL TIME IS APPROXIMATELY 30 MINUTES AND THE AVERAGE HOUSEHOLD INCOME IS $54,177. BARRY COUNTY IS UNIQUELY LOCATED IN THE MIDDLE OF FOUR (4) LARGER METROPOLITAN AREAS: GRAND RAPIDS, LANSING, KALAMAZOO, AND BATTLE CREEK. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: THE MISSION OF PENNOCK HEALTH IS TO PROVIDE QUALITY HEALTH SERVICES IN A PERSONAL, PROFESSIONAL, AND PROGRESSIVE MANNER IN PARTNERSHIP WITH OUR COMMUNITY. OUR MISSION IS CLOSELY CORRELATED WITH THE HEALTH AND SOCIOECONOMIC DATA COLLECTED. THIS DATA ALONG WITH OUR MISSION ASSISTS IN STRATEGIC PLANNING EFFORTS TO ALIGN THE SERVICES PROVIDED BY PENNOCK WITH THE TRUE COMMUNITY HEALTH NEED. SPONSORSHIPS AND DONATIONS OR VOLUNTEER TIME IS DIRECTED IN THE AREAS OF HEALTH STATUS IDENTIFICATION, EVALUATION, AND EDUCATION WHERE PREVENTION OR MANAGEMENT IS TAUGHT. PENNOCK COLLEAGUES VOLUNTEER TIME AND MATERIALS TO PROVIDE HEALTH SCREENINGS, FREE OR AT A REDUCED RATED DEPENDING ON THE SERVICE BEING PROVIDED. COLLEAGUES ALSO COLLABORATE WITH LOCAL BUSINESSES TO EDUCATE THEIR EMPLOYEES ON HEALTH IMPROVEMENT AND COST SAVINGS OPTIONS TO EMPLOYERS, WHICH HELPS THE LOCAL ECONOMY AND IMPROVES OVERALL HEALTH OF OUR WORKFORCE. FINALLY, PENNOCK PROVIDES A LOCATION FREE OF CHARGE TO HOUSE THE BARRY COMMUNITY FREE CLINIC AND HABITAT FOR HUMANITY TO ALLEVIATE OVERHEAD AND ALLOW THESE SERVICES TO ASSIST THOSE IN NEED IN OUR COUNTY. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE CONTINUALLY USED TO FUND IMPROVEMENTS IN PATIENT CARE AND MEDICAL EDUCATION.PENNOCK OPERATES TWO ADDITIONAL OUTPATIENT DIAGNOSTIC CENTERS, IONIA DIAGNOSTIC CENTER, 537 W. MAIN ST., IONIA, MICHIGAN 48846 AND LAKE ODESSA DIAGNOSTIC CENTER, 4294 LAUREL DR., SUITE #4, LAKE ODESSA, MICHIGAN 48849, AND AN URGENT CARE CENTER, STATE STREET CENTER AND DIAGNOSTIC IMAGING CENTER, 1108 W. STATE STREET CENTER, HASTINGS, MICHIGAN 49058. WE ALSO PROVIDE ONSITE OCCUPATIONAL MEDICINE WITH A PARTNER EMPLOYER LOCATED IN MIDDLEVILLE, MICHIGAN. | OtherInformation |
| Reports Filed With States | MI | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sheryl Lewis Blake | |||||||||||||
| 258880 | 0 | 0 | 0 | 3790 | 0 | 22000 | 0 | 20203 | 0 | 304873 | 0 | 0 | 0 |
| Connie S Downs | |||||||||||||
| 180595 | 0 | 0 | 0 | 6300 | 0 | 16000 | 0 | 13932 | 0 | 216827 | 0 | 0 | 0 |
| Carla Wilson-Neil | |||||||||||||
| 160118 | 0 | 0 | 0 | 3746 | 0 | 20668 | 0 | 14686 | 0 | 199218 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 1a | ReturnReference |
| Explanation | THE HEALTH AND WELLNESS CENTER IS AVAILABLE TO ALL EXECUTIVE, DIRECTORS, AND OFFICERS. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| Michigan State Hospital Finance Authority Healthcare Equipment Loan 2003 | ||||||
| 382889417 | 59465E5V1 | 2003-12-10 | 4300000 | Healthcare Equipment #03 | 0 | 0 |
| Michigan State Hospital Finance Authority Healthcare Equipment Loan 2004 | ||||||
| 382889417 | 59465E6T5 | 2004-05-26 | 6000000 | Healthcare Equipment #26 | 0 | 0 |
| Michigan State Hospital Finance Authority Healthcare Equipment Loan 2006 | ||||||
| 382889417 | 59465HDY9 | 2006-09-27 | 3031165 | Healthcare Equipment #58 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|
| 4300000 | 51600 | 4300000 | 2003 | 0 | 0 | 1 | 1 |
| 6000000 | 72000 | 6000000 | 2005 | 0 | 0 | 1 | 1 |
| 3031165 | 36374 | 3031165 | 2006 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 | 1 |
| 0 | 0 | 0 | 0 | 1 | 1 |
| 0 | 0 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 1 | 0 | 0 | 0 | 0 |
| 0 | 1 | 0 | 0 | 0 | 0 |
| 0 | 1 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| KIM NORRIS MD | |||
| PROVIDER/BOARD MEMBER/COUNTY HEALTH PLAN | 730168 | PAYMENTS UNDER THE INDIGENT CARE AGREEMENT TO THE BARRY EATON HEALTH PLAN | 0 |
| DAVID PARKER MD | |||
| PROVIDER/BOARD MEMBER | 66504 | CONTRACT SERVICE OF PROFESSIONAL FEES | 0 |
| SCOTT BRASSEUR MD | |||
| PROVIDER/BOARD MEMBER/TREASURER | 81052 | CONTRACT SERVICE OF PROFESSIONAL FEES | 0 |
| HASTINGS CITY BANK | |||
| NANCY GOODIN/BOARD MEMBER/MARKETING AND TRAINING DIRECTOR | 46054 | INVESTMENT SERVICES | 0 |
| BRUCE GEE | |||
| CHAIRMAN/ATTORNEY | 1680 | LEGAL SERVICES | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | THE BOARD OF TRUSTEES RECEIVED A TRAINING, CONDUCTED BY OUR INDEPENDENT PUBLIC ACCOUNTANTS ON THE RULES AND REQUIREMENTS OF THE IRS FORM 990. ON APRIL 26, 2011 THE COMPLETED IRS FORM 990 WILL BE REVIEWED. THE BOARD OF DIRECTORS WILL VOTE TO APPROVE THE FORM 990 AS A TRUE REPRESENTATION OF THE HOSPITAL'S ACTIVITY DURING THE FISCAL YEAR. |
| Form 990, Part VI, Section B, line 12c | ANNUAL CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY BOARD MEMBERS. MEMBERS ARE RESPONSIBLE FOR FULL DISCLOSURE OF POTENTIAL CONFLICTS WHICH ARE DOCUMENTED IN THE MINUTES. ANY INDIVIDUAL WITH A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING ON ANY RELEVANT ITEMS. |
| Form 990, Part VI, Section B, line 15 | PENNOCK USES SALARY SURVEYS ALONG WITH HIRING A CONSULTING COMPANY IN ASSISTING WITH SETTING WAGES FOR THE OFFICER'S AND KEY EMPLOYEES. |
| Form 990, Part VI, Section C, line 19 | THE 990 IS AVAILABLE UPON REQUEST. |
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 |
|---|---|---|---|---|---|---|---|---|---|
| Pennock Foundation | |||||||||
| 1009 WEST GREEN STREET | HASTINGS | MI | 49058 | 382713275 | FOUNDATION | MI | 501(C)(3) | 11 | PENNOCK HEALTH SYSTEMS |
| Pennock Healthcare System | |||||||||
| 1009 WEST GREEN STREET | HASTINGS | MI | 49058 | 382713276 | Parent Organization | MI | 501(C)(3) | 11 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENNOCK VENTURES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1009 WEST GREEN STREET | AddressLine1 |
| City | HASTINGS | City |
| State | MI | State |
| ZIP Code | 49058 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382712819 | EIN |
| Primary Activity | REAL ESTATE | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pennock Healthcare System | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| PENNOCK VENTURES | |
| J | 428814 |
| PENNOCK VENTURES | |
| P | 11659 |
| PENNOCK FOUNDATION | |
| C | 49463 |
| PENNOCK FOUNDATION | |
| M | 10000 |
| PENNOCK FOUNDATION | |
| N | 23773 |
| PENNOCK VENTURES | |
| D | 544000 |
| PENNOCK VENTURES | |
| A | 112046 |
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