2011-02-09T09:27:02-06:00 2010-06-30 Plante & Moran PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2009-07-01 386005550 HILLSDALE COMMUNITY HEALTH CENTER HILL 5174374451 168 SOUTH HOWELL STREET HILLSDALE MI 49242 VALERIE FETTERS 5174374451 2011-02-03 1 Carol LaLonde CPA 2695674500 2009 2016-02-24 21:20:13Z DUKE ANDERSON 168 SOUTH HOWELL STREET HILLSDALE MI 49242 57961192 0 X WWW.HCHC.COM X 1950 MI SHORT-TERM, acute care hospital facility, including a skilled nursing unit providing inpatient and outpatient services in the Hillsdale, Michigan area. hchc averages over 3,000 admissions per year, 120,000 outpatient visits per year, and 25,000 emergency department visits per year. hchc gives back to the community in many ways, including supporting the free clinic and providing community scholarships for allied health professions. 11 9 493 75 0 0 158395 33832 54929279 56681810 269819 155366 814385 680238 56171878 57551246 0 0 23630692 23946601 0 0 32862181 31800675 56492873 55747276 -320995 1803970 44947965 45267496 26166540 23803846 18781425 21463650 HILLSDALE COMMUNITY HEALTH CENTER IS AN INDEPENDENT, PROGRESSIVE HEALTH CARE TEAM. WE WILL CONTINUE TO UTILIZE THE LATEST TECHNOLOGY AND EXPERTISE WHILE DELIVERING COMPASSIONATE, QUALITY CARE. WE ARE LARGE ENOUGH TO BE OF SERVICE...SMALL ENOUGH TO CARE. 0 0 48688871 56681810 Short-term, acute care hospital facility including a skilled nursing unit and psychiatric unit providing inpatient and outpatient services to the Hillsdale, Michigan area. hchc averages over 3,000 admissions per year, 120,000 outpatient visits per year, and 25,000 emergency department visits per year. hchc gives back to the community in many ways, including supporting the free clinic and providing community scholarships for allied health professions. 48688871 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 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 90 0 493 1 0 1 CJ 0 0 0 0 0 0 0 11 9 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MI X VALERIE FETTERS 5174374451 168 S HOWELL STREET HILLSDALE MI 49242 beverly marks 1.00 X X 0 0 0 GREGORY BAILEY 1.00 X X 0 0 0 PARKE HAYES 1.00 X X 0 0 0 father THOMAS BUTLER 1.00 X 0 0 0 KEITH BARON MD 1.00 X 0 0 0 DEBRA LUSTY DO 1.00 X 0 0 0 ALFRED BEDIAKO MD 1.00 X 0 0 0 CHARLES MAURER 1.00 X X 0 0 0 CRAIG CONNOR 1.00 X 0 0 0 MURIEL ALEXANDROWSKI 1.00 X 0 0 0 DIANE PHILIPP 1.00 X 0 0 0 DAVID GOSSAGE DO 1.00 X 0 0 0 ROBERT HENTHORNE 1.00 X 0 0 0 DALE MCCRIRIE DO 1.00 X 0 0 0 VALERIE FETTERS 40.00 X 140382 0 21058 duke anderson 40.00 X 219064 0 32859 CYNTHIA MORGAN 40.00 X 110582 0 16588 JANET MARSH 40.00 X 108052 0 16208 daniel baxter 40.00 X 258334 0 38750 KEVIN ANDERSON 40.00 X 497843 0 62750 ravinder sharma 40.00 X 369825 0 55474 1704082 0 243687 8 0 1 0 REYNOLDS PHARMACY CORP 5036 HARRIET DRIVe JACKSON MI 49203 PHARMACY MANAGEMENT 979863 CPSI 660 wall street MOBILE AL 36695 BILLING/COLLECTION SERVICES 560535 HILLSDALE PULMONARY CRITICAL CARE 451 hidden meadows dr HILLSDALE MI 49242 SLEEP LAB MANAGEMENT 418500 ANESTHESIA STAFFING CONSULTANTS 30200 telegraph ste 220 BINGHAM FARMS MI 48025 ANESTHESIA SERVICES 397300 hillsdale physical therapy 1500 meadow lane hILLSDALE MI 49242 physical therapist 382002 10 33832 33832 NET PATIENT REVENUE 621110 56681810 56681810 56681810 342907 342907 4415 25240 -20825 -20825 -20825 192870 707 290404 90714 -97534 -90007 -187541 -187541 21895 3588 18307 18307 OTHER INCOME 900099 384458 384458 CAFETERIA SALES 900099 172755 172755 EMPLOYEE PRESCRIPTION 900099 125543 125543 682756 57551246 56681810 0 835604 359446 359446 18567183 16359467 2207716 477707 412912 64795 3132966 2708018 424948 1409299 1218145 191154 104200 89075 15125 84000 71807 12193 191 191 7012595 5994875 1017720 244836 209298 35538 1941187 1654148 287039 198710 169867 28843 584004 504791 79213 2748193 2375435 372758 medical supplies 12242640 10465611 1777029 PROVISION FOR DOUBTFUL 5367670 5367670 REPAIR AND MAINTENANCE 1035320 885042 150278 DUES 237129 202710 34419 55747276 48688871 7058405 0 5710 118021 3140304 5442415 151309 134245 10845022 8356458 1110278 1799362 314384 258392 232130 165269 44288256 30576384 15577497 13711872 8106303 9323288 4300376 4528433 1164652 1429741 44947965 45267496 9236525 8977020 9221824 8876824 5194700 4851478 2513491 1098524 26166540 23803846 X 18570759 21292978 210666 170672 18781425 21463650 44947965 45267496 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 103162 103162 26011342 18332883 7678459 1058407 745969 312438 16313105 11497532 4815573 802240 802240 13711872 ASSETS LIMITED AS TO USE 4528433 F 4528433 COST REPORT SETTLEMENTS 1098524 1098524 57551246 55747276 1803970 878255 878255 2682225 58458329 878255 878255 57580074 -28828 -28828 57551246 55776104 28828 28828 55747276 0 55747276 Part XII, Line 4b - Other Adjustments: special events expenses: -3588. rental expenses: -25240. Part XIII, Line 2d - Other Adjustments: SPECIAL EVENTS EXPENSES: 3588. rental expenses: 25240. GOLF OUTING 21895 21895 725 2074 789 21895 21895 725 2074 789 3588 18307 1 1 1 X 1 X 0 1 1 0 1 1 567140 567140 0.01020 8278209 9103027 -824818 0.00000 8845349 9103027 -257678 0.01020 650776 327279 323497 0.00580 15350 15350 0.00030 666126 327279 338847 0.00610 9511475 9430306 81169 0.01630 237324 237324 0.00430 237324 237324 0.00430 1 2684000 1023373 16434505 16474987 -40482 X 1 0 HILLSDALE COMMUNITY HEALTH CENTER

168 S HOWELL STREET HILLSDALE MI 49242

X X X X CENTER FOR PSYCHIATRIC CARE

168 S HOWELL STREET HILLSDALE MI 49242

INPATIENT PYSCH UNIT MAC MCGUIRE SKILLED NURSING FACILITY

168 S HOWELL STREET HILLSDALE MI 49242

INPATIENT SNF UNIT Part VI, Line 2: CURRENTLY THE NEEDS ARE ASSESSED THROUGH GENERAL CONVERSATIONS WITH THE HEALTH DEPARTMENT, THE FREE CLINIC, AND OTHER MEMBERS OF THE COMMUNITY. WE ARE WORKING ON INSTITUTING A FULL NEEDS ASSESSMENT. Part VI, Line 3: THE CHARITY CARE POLICY AND PAYMENT OPTIONS POLICY ARE LISTED ON OUR WEBSITE. THERE ARE PATIENT FINANCIAL COUNSELORS AVAILABLE IN AN OFFICE ADJACENT TO THE HOSPITAL LOBBY FOR HELP WITH BILLS AND A MEDICAID SPECIALIST ON SITE TO HELP WITH THE MEDICAID APPLICATION AND OTHER OPTIONS. Part VI, Line 4: HILLSDALE COMMUNITY HEALTH CENTER SERVES 47,000 RESIDENTS OF HILLSDALE COUNTY. THIS RURAL, FARMING COMMUNITY IS CURRENTLY AT 14.9% UNEMPLOYMENT RATE. WITH MANY LOCAL INDUSTRIES CLOSING ITS DOORS, IT HAS BEEN EXTREMELY DIFFICULT FOR OUR RESIDENTS TO MAINTAIN THEIR HOME MORTGAGES AND HEALTH INSURANCE. OUR PAYOR MIX IS CURRENTLY 60% MEDICARE AND 14% MEDICAID. Part VI, Line 5: HILLSDALE COMMUNITY HEALTH CENTER PROVIDES NUMEROUS COMMUNITY ACTIVITIES IN SUPPORT OF THE RESIDENTS OF HILLSDALE COUNTY, INCLUDING SENIOR SUNDAY WHERE LUNCH IS SERVED TO THE SENIOR COMMUNITY MEMBERS AND A SPEAKER DISCUSSES HEALTH ISSUES AND OTHER TOPICS RELATING TO THIS AGE GROUP. IN ADDITION, THERE ARE SEVERAL SUPPORT GROUPS AND CLASSES, INCLUDING THE BREAST CANCER SUPPORT GROUP, BREAST FEEDING CLASSES, BIRTHING CLASSES, NUTIRTION EDUCATION AND DIABETES EDUCATION CLASSES. THERE ARE PERIODIC HEALTH SCREENINGS SUCH AS VARICOSE VEIN, FOOT PAIN, CHOLESTEROL, AND COPD SCREENINGS. HILLSDALE COMMUNITY HEALTH CENTER ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM. NUMBEROUS HIGH SCHOOL AND COMMUNITY SCHOLARSHIPS HAVE BEEN GRANTED FOR FULL TUITION FOR ALLIED HEALTH DEGREES. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 VALERIE FETTERS 140382 0 0 0 0 0 2808 0 18250 0 161440 0 0 0 duke anderson 219064 0 0 0 0 0 4381 0 28478 0 251923 0 0 0 daniel baxter 258334 0 0 0 0 0 5167 0 33583 0 297084 0 0 0 KEVIN ANDERSON 418334 0 0 0 79509 0 8367 0 54383 0 560593 0 0 0 ravinder sharma 369825 0 0 0 0 0 7397 0 48077 0 425299 0 0 0 MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 NONEAVAIL 2003-11-13 5000000 NEW SPACE FOR SURGICAL SERVICES PLUS MISCELLANEOUS EQUIPMENT 1 0 MICHIGAN STATE HOSPITAL FINANCE AUTHORITY 382889417 NONEAVAIL 2006-09-14 2200000 NEW SPACE FOR INPATIENT PSYCHIATRIC UNIT 1 0 5000000 182351 57267 4760382 2005 0 0 1 1 2200000 305660 22522 1871818 2007 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 Form 990, Part VI, Section B, line 11 THE 990 IS PRESENTED TO THE BOARD FOR REVIEW. CHANGES AND QUESTIONS ARE COMMUNICATED TO THE CFO. Form 990, Part VI, Section B, line 12c BOARD MEMBERS ARE REQUIRED TO DISCLOSE OF ANY CONFLICTS OF INTEREST ANNUALLY. Form 990, Part VI, Section B, line 15 THERE IS A SEPARATE COMPENSATION COMMITTEE OF THE GOVERNING BODY WHICH CONSULTS WITH THE COMPANY'S LEGAL FIRM FOR COMPARABILITY DATA. Form 990, Part VI, Section C, line 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 2C: THERE HAS BEEN NO CHANGE IN PROCESS FROM PRIOR YEAR.