2011-11-10T15:53:09-05:00 2010-12-31 990 2010-01-01 383426063 CARO COMMUNITY HOSPITAL CARO 401 N HOOPER ST PO BOX 435 CARO MI 48723 WILLIAM P MILLER 9896733141 2011-11-09 false 2010 2016-02-24 21:20:13Z WILLIAM P MILLER 14029550 false X WWW.CCH-MI.ORG X 1999 MI CARO COMMUNITY HOSPITAL A COMMUNITY-MINDED HEALTHCARE SYSTEM IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE 7 4 201 50 0 0 18774 28433 13894996 13828051 11011 36889 44441 94030 13969222 13987403 0 0 7172234 7845505 0 0 6789859 6570682 13962093 14416187 7129 -428784 7732770 7933659 4193281 4618763 3539489 3314896 CARO COMMUNITY HOSPITAL A COMMUNITY-MINDED HEALTHCARE SYSTEM IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE false false 11591747 PROVISION OF NEEDED MEDICAL SERVICES TO THE COMMUNITY 11591747 true false false false false false false false true true false false true true false true false false false false false false false false false true false false false true false false false false false true true true false false false false false true false false false false true 28 0 true 201 true false false false false false false false false false false false false false false false X 7 4 false false false false false false false true true false false true true true true true true true false false X X RONALD D SREBINSKI CFO 9896733141 401 N HOOPER ST PO BOX 435 CARO MI 48723 DALE PERZ 2.00 X X 62378 0 0 DAN BRISTOL 2.00 X X 0 0 0 DON DUGGAR 2.00 X 0 0 0 DR AFONSO FERREIRA 2.00 X 0 0 0 LYNN LAETHEM 2.00 X X 0 0 0 RUBY REID 2.00 X 0 2300 0 WILLIAM P MILLER 40.00 X X X X 157989 0 31371 DR JULIE SAWADE 40.00 X 166405 0 31871 DR RICHARD MOYER 32.00 X 228597 0 39144 JAMES SINGLES 40.00 X 117476 0 31120 MIKE MIHORA 40.00 X 101457 0 27675 SUE MORRIS 40.00 X 115481 0 13256 949783 2300 174437 6 false true false HOSPITAL MD 200 W PARK DRIVE STE 325 PEACHTREE CITY GA 30269 E R PHYSICIANS 1098000 BAUMAN and BAUMAN 318 CHIP ROAD AUBURN MI 48611 ANESTHESIA SERVICE 210200 2 28433 28433 NET PATIENT SERVICE REV 900099 13828051 13828051 13828051 36889 36889 37561 42147 -4586 -4586 -4586 2137 2137 2137 CAFETERIA 722210 18845 18845 HPSA PAYMENTS 900099 27617 27617 50017 50017 96479 13987403 13922081 0 36889 157989 157989 5447749 4249728 1198021 230197 174513 55684 1582617 1199787 382830 426953 324079 102874 61220 61220 31000 31000 1389372 1389372 105166 105166 22915 59 22856 595020 544658 50362 45866 10807 35059 164000 164000 501130 501130 154114 154114 SUPPLY COSTS 1495505 1416536 78969 DUES AND SUBSCRIPTIONS 86924 14554 72370 PROVISION FOR BAD DEBTS 961474 961474 PURCHASED SERVICES 558477 379711 178766 QAAP TAX PAYMENTS 281422 281422 117077 107225 9852 14416187 11591747 2824440 0 1433181 802378 904530 1117800 363342 363055 47139 35052 11948446 6822389 4541522 5126057 443056 489317 7732770 7933659 1020688 960379 2146590 2427008 1026003 1231376 4193281 4618763 X 3534489 3304896 5000 5000 5000 3539489 3314896 7732770 7933659 X -428784 204191 X false true false X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5000 5000 5000 25 25 5000 1.00000 false true true 133521 133521 5616466 2284985 3331481 12112 10563 1549 6164568 4526841 1637727 21779 21779 5126057 INT IN CCH ENDOWMENT FOUNDATIO 484317 ASSETS LIMITED AS TO USE 5000 489317 ACCOUNT PAYABLE TO THIRD PARTI 502713 ACCRUED AND OTHER LIABILITIES 728663 1231376 13987403 14416187 -428784 -428784 13964228 42147 42147 13922081 65322 65322 13987403 14458334 42147 42147 14416187 14416187 Other revenues non included on Form 990 Part XII line 2d EXPENSES RELATING TO RENTAL COST OFFSET 42147 02 Other revenues included on Form 990 Part XII line 4b INTEREST INCOME 36889 CONTRIBUTIONS 28433 03 Other expenses not included on Form 990 Part XIII line 2d EXPENSES RELATING TO RENTAL COST OFFSET 42147 true true false true X true true false true false 38650 38650 0.00300 1911327 922661 988666 0.07730 1949977 922661 1027316 0.0803 129229 200 129029 0.0101 129229 200 129029 0.0101 2079206 922861 1156345 0.0904 true 670917 186582 4790476 4790476 X true true 1 1 CARO COMMUNITY HOSPITAL

401 N HOOPER STREET CARO MI 48723

X X X X CARO COMMUNITY HOSPITAL 1 false false false false 01 Other charity care criteria description Part I line 3c THE HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CHARITY CARE SERVICES 02 Related organization annual community benefit report Part I line 6a THE ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR INCLUSION IN THE MICHIGAN HOSPITAL ASSOCIATION COMMUNITY BENEFIT REPORT THE REPORT IS NOT RELEASED TO THE GENERAL PUBLIC 03 Bad debt description footnote Part III line 4 MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED UPON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE 04 Debt expense included Part I line 7 col f BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 THAT IS REMOVED FOR PURPOSES OF SCHEDULE H LINE 7 COLUMN F IS 961474 05 Costing methodology explanation Part I line 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN LINES 7A-D IS BASED ON THE COST-TO-CHARGE RATIOS LINES 7E-I IS BASED ON ACTUAL COST 06 Collection practices Part III line 9b IF THE PATIENT IS NOT ABLE TO MAKE PAYMENT ARRANGEMENTS THE STAFF WILL VERBALLY DETERMINE IF THE PATIENT IS POTENTIALLY ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL CHARITY CARE POLICY PATIENTS WHO APPEAR TO MEET THE CARO COMMUNITY HOSPITAL CRITERIA ARE REFERRED TO THE SOCIAL WORKER FOR FURTHER REVIEW IN ACCORDANCE WITH THE HOSPITAL CHARITY CARE POLICY 07 Needs assessment Part VI question 2 ORGANIZATION COMMUNICATED WITH STATE AND LOCAL AGENCIES TO DETERMINE THE HEALTHCARE NEEDS OF THE COMMUNITY EXAMPLES OF SERVICES PROVIDED BASED ON COMMUNITY NEEDS ARE IMMUNIZATIONS VACCINES SPORTS PHYSICALS SENIOR AND HEALTH FAIRS FIRST AID BOOTH AND DIABETIC CLASSES 08 Patient education Part VI question 3 EVERY UNINSURED PATIENT THAT IS AN INPATIENT OUTPATIENT SURGICAL OBSERVATION OR INCURS MORE THAN 5000 IN MEDICAL EXPENSES RECEIVES A CHARITY CARE PACKAGE THE PACKAGE INCLUDES A CHARITY CARE AND MEDICAID APPLICATION AND A HUMAN SERVICES REFERRAL FORM ALL OTHER NON-INSURED PATIENTS MAY REQUEST A CHARITY CARE APPLICATION AT ANY TIME 09 Community information Part VI question 4 ORGANIZATION IS LOCATED IN TUSCOLA COUNTY WHICH HAS A POPULATION OF APPROX 56000 CARO HAS A POPULATION OF APPROX 4200 TUSCOLA COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES THE UNEMPLOYMENT RATE IN TUSCLOA COUNTY IS 16 10 Promoting community health Part VI question 5 ORGAINZATION PROVIDES SPECIAL CLINICS IN CARO SO PATIENTS DO NOT HAVE TO COMMUTE 11 Affiliated health care system Part VI question 6 NA 12 State filings Part VI question 7 NA X X false false false false false false false false false WILLIAM P MILLER 157989 0 0 0 0 0 0 0 31371 0 189360 0 183822 0 DR RICHARD MOYER 228597 0 0 0 0 0 0 0 39144 0 267741 0 258964 0 DR JULIE SAWADE 166405 0 0 0 0 0 0 0 31871 0 198276 0 181859 0 DALE PERZ - PERZPECTIVES BOARD MEMBER 62378 MARKETING SERVICES false 01. Form 990 governing body review (Part VI, line 11) EACH BOARD MEMBER WILL RECEIVE A COMPLETE COPY OF THE RETURN THE CEO AND CFO WILL REVIEW THE RETURN DURING THE NOVEMBER MEETING OF THE BOARD OF TRUSTEES 02. Conflict of interest policy compliance (Part VI, line 12c) THE CONFLICT OF INTEREST POLICY IS MONITORED THROUGH DISCUSSION WITH THE CEO AND EACH BOARD MEMBER 03. CEO, executive director, top management comp (Part VI, line 15a) THE BOARD UTILIZES THE MICHIGAN HEALTH AND HOSPITAL ANNUAL SURVEY TO DETERMINE THE COMPENSATION LEVEL FOR THE CEO 04. Governing documents, etc, available to public (Part VI, line 19) THE GOVERNING DOCUMENTS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC 05. Explanation of other changes in net assets or fund balances (Part XI, line 5) CCH FOUNDATION 46261 CONTRIBUTION OF PROPERTY-RADIO TOWER GRANT 143731 CONTRIBUTIONGRANT-EQUIPMENT 9199 TEMPORARY RESTRICTED CONTRIBUTION 5000 CCH HEALTH CARE ALLIANCE 401 N HOOPER ST CARO MI 487230435 383426058 PARENT TO CCH MI 501C3 III-F1 NA false CCH ENDOWMENT FOUNDATION 401 N HOOPER ST CARO MI 487230435 382422995 FOUNDATION MI 501C3 III-F1 NA false false false false false false false false false false false false false false false false false false false