Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
MARLETTE REGIONAL HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
2770 MAIN STREET PO BOX 307
 
Room/suite
City or town, state or country, and ZIP + 4
MARLETTE, MI484530307
D Employer identification number

38-1507302
E Telephone number

G Gross receipts $ 34,033,163
F Name and address of principal officer:
DAN BABOCK CEO
2770 MAIN STREET PO BOX 307
MARLETTE,MI484530307
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MARLETTEREGIONALHOSPITAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1951
M State of legal domicile: MI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE MEDICAL AND SURGICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MRH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY'S HEALTH STATUS WILL BE CONSIDERED WHERE THE NEED AND/OR THE INDIVIDUAL'S INABILITY TO PAY CO-EXIST. THESE ACTIVITIES INCLUDE ACUTE, EMERGENCY AND OUTPATIENT SERVICES IN ADDITION TO WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 8
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 8
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 511
6 Total number of volunteers (estimate if necessary) .... 6 200
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 223,962 399,032
9 Program service revenue (Part VIII, line 2g) ......... 32,450,043 32,560,940
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,442,372 84,173
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 390,016 296,959
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 34,506,393 33,341,104
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4) ....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 19,843,836 19,374,795
16a Professional fundraising fees (Part IX, column (A), line 11e)....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet134,272    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 13,805,816 13,288,528
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 33,649,652 32,663,323
19 Revenue less expenses. Subtract line 18 from line 12...... 856,741 677,781
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 38,989,044 39,425,284
21 Total liabilities (Part X, line 26)............ 18,353,751 18,145,165
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 20,635,293 21,280,119
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO PROVIDE MEDICAL AND SURGICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MRH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY'S HEALTH STATUS WILL BE CONSIDERED WHERE THE NEED AND/OR THE INDIVIDUAL'S INABILITY TO PAY CO-EXIST. THESE ACTIVITIES INCLUDE ACUTE, EMERGENCY AND OUTPATIENT SERVICES IN ADDITION TO WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 28,440,215 including grants of $   ) (Revenue $ 33,308,148 )
DURING FISCAL YEAR 2010-2011 MARLETTE REGIONAL HOSPITAL SERVED 869 INPATIENTS, PROVIDED CARE TO 45,740 OUTPATIENTS, INCLUDING 8,198 EMERGENCY DEPARTMENT PATIENTS, AND SERVED 28,295 PATIENTS IN ITS OWNED MEDICAL AND RURAL HEALTH PRACTICES. RECOGNIZING ITS MISSION TO THE COMMUNITY, THE HOSPITAL PARTICIPATES IN THE FEDERAL GOVERNMENT'S MEDICARE PROGRAM AND NUMEROUS MEDICAID HEALTH PLANS, OFTEN PROVIDING CHARITY CARE OR SERVICE AT RATES OF REIMBURSEMENT THAT ARE BELOW THE HOSPITAL'S ACTUAL COST. IN THE LAST FISCAL YEAR, THE NON-REIMBURSED VALUE OF PROVIDING CARE TO ALL OF MRH'S PATIENTS WAS APPROXIMATELY 20,774,975 REPRESENTING A WRITE-DOWN OF 37.51 PERCENT OF THE HOSPITAL'S CHARGES, INCLUDING CHARITY CARE EXPENSES OF 296,811. ADDITIONALLY, THE HOSPITAL'S ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS TOTALED OVER 2,150,290 IN FY 11. OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES THAT MRH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. A SAMPLING OF THESE COMMUNITY BENEFITS IS PROVIDED BELOW: EDUCATIONAL SERVICES/PROGRAMS "ABUSE AND NEGLECT RECOGNITION TRAINING FOR COMMUNITY AND HOSPITAL STAFF "CAREER GUIDANCE FOR AREA SCHOOL STUDENTS "COOPERATIVE PROFESSIONAL TRAINING WITH LOCAL COLLEGES "CPR TRAINING FOR THE COMMUNITY AND PUBLIC SAFETY AGENCIES "DISEASE/CONDITION-SPECIFIC EDUCATION, E.G., DIABETES "EDUCATION/COUNSELING FOR FAMILIES OF PATIENTS "EDUCATION/COUNSELING FOR PATIENTS "EDUCATIONAL PROGRAMS FOR EMPLOYEES (ADULT EDUCATION) "ORGAN DONATION INFORMATION CAMPAIGNS "RESOURCE LIBRARY "SCHOOL HEALTH PROGRAMS "SPEAKERS BUREAU "SUPPORT GROUPS FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY "TRAINING OF PUBLIC HEALTH AND SAFETY PERSONNEL "SAFE DRIVING PROGRAMS FOR ELDERLY DRIVERS HEALTH PROMOTION AND PREVENTIONS ACTIVITIES "BLOOD PRESSURE CLINICS "DISCHARGE PLANNING WITH FOLLOW-UP SUPPORT PROGRAMS "DRUG REVIEW FOR SENIOR CITIZENS "HEALTH PROMOTION/WELLNESS PROGRAMS "HEALTH SCREENING/HEALTH FAIRS "HOME SAFETY AND FIRST AID "NUTRITION AND WEIGHT CONTROL "RURAL HEALTH OUTREACH SERVICES "SMOKING CESSATION CLINICS "STRESS MANAGEMENT "WORK SITE HEALTH PROMOTION SERVICE EMERGENCY SERVICES/PROGRAMS "EMERGENCY SERVICES DEPARTMENT "ADVANCED LIFE SUPPORT AMBULANCE SERVICE "CRISIS INTERVENTION "FIRE AND POLICE ASSISTANCE "HELICOPTER TRANSFER ASSISTANCE CLINICAL SERVICES "CERTIFIED RURAL HEALTH CLINICS "CHILDHOOD IMMUNIZATIONS "PRIMARY CARE SERVICES "ACUTE MEDICAL AND SURGICAL SERVICES "RESIDENTIAL AND HOME-BASED HOSPICE SERVICES "UNIQUELY-ACCREDITED HOSPITAL, LABORATORY, CARDIOPULMONARY, AND LONG-TERM CARE SERVICES "MOBILE PET AND BONE DENSITY TESTING TECHNOLOGY "COORDINATION OF PATIENT CARE SERVICES IN HOSPITAL "FREE OR LOW COST SERVICES TO LOW INCOME FAMILIES "GENERAL HEALTH SCREENING CLINICS "RESPIRATORY/PULMONARY DISEASE SERVICES "SCHOOL HEALTH CLINICS (PRIMARY CARE) "SCHOOL SPORTS PHYSICALS "SKILLED NURSING SERVICES/INTERMEDIATE CARE FACILITY NON-CLINICAL HOSPITAL SERVICES "ADVOCACY ON BEHALF OF SPECIFIC PATIENTS NEEDING INTERVENTION WITH PUBLIC AGENCIES (SOCIAL SERVICES) "FREE MEETING ROOMS FOR COMMUNITY GROUPS "FREE OR LOW COST MEALS "GUIDANCE AND REFERRAL TO COMMUNITY SERVICES AND PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICAID "MEALS FOR FAMILY MEMBERS "TRANSLATION OR INTERPRETER SERVICES FOR NON-ENGLISH SPEAKING PATIENTS SUPPORT FOR OTHER HEALTH CARE PROVIDERS "RADIATION AND CHEMOTHERAPY SERVICES "VISITING MEDICAL AND SURGICAL SPECIALISTS TO COMPLEMENT PRIMARY CARE PHYSICIANS' CARE "SUPPORT FOR BLOOD DRIVES "DONATION OF USED EQUIPMENT TO OTHER PROVIDERS "PHYSICIAN REFERRAL SERVICES "PARTNER IN REGIONAL RURAL HEALTH NETWORKS WORKING RELATIONSHIP WITH OTHERS "CIVIC ORGANIZATIONS SUCH AS LIONS CLUB AND TOYS FOR TOTS "AMERICAN ASSOCIATION OF RETIRED PERSONS "COMMUNITY-BASED BUSINESS GROUPS SUCH AS CHAMBERS OF COMMERCE "ECONOMIC DEVELOPMENT AGENCIES "HOME HEALTH AGENCIES "HOSPICES "LOCAL SCHOOLS AND COLLEGES "MENTAL HEALTH CENTERS "NURSING HOMES "SENIOR CITIZENS ORGANIZATIONS "STATE AND LOCAL AGENCIES AND ORGANIZATIONS MARLETTE REGIONAL HOSPITAL IS COMMITTED TO SERVING OUR PATIENTS IN WAYS THAT RESPECT THE ORIGINAL VALUES OF OUR COMMUNITY - A COMPASSION FOR OUR NEIGHBORS AND A SENSE OF DUTY TO SERVE THOSE IN NEED. IN RESPECTING THESE VALUES, MARLETTE REGIONAL HOSPITAL ACKNOWLEDGES ITS OBLIGATION TO OFFER SERVICES TO PATIENTS THAT MAY NOT BE ABLE TO FULLY AFFORD THE CARE THEY NEED, WHILE ALSO SERVING THE HEALTH IMPROVEMENT NEEDS OF OUR LARGER COMMUNITY. TO THAT END, THE HOSPITAL HAS ADOPTED POLICIES THAT DESCRIBE HOW SERVICES ARE DISCOUNTED AND HOW CHARITY CARE IS DETERMINED AND OFFERED.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 28,440,215
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1.....................
34
 
No
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
50
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
511
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
8
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
 
No
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JIM SINGLES CFO
2770 MAIN STREET
MARLETTE,MI48453
(989) 635-4000
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) MEREDITH LYONS
TRUSTEE
   X           0 0 0
(2) RALPH DESHETSKY
TRUSTEE
   X           0 0 0
(3) DORIS HUNTOON
SEC/TREASURE
   X   X       0 0 0
(4) DONALD ROBBINS
TRUSTEE
   X           0 0 0
(5) LES PHILLIPS
CHAIRMAN
   X   X       0 0 0
(6) CHRIS CLARK
TRUSTEE
   X           0 0 0
(7) SCOTT ORR
TRUSTEE
   X           0 0 0
(8) SUE COOK
VICE-CHAIRMA
   X   X       0 0 0
(9) DAN BABCOCK
CEO
 40.00     X       218,001 0 8,944
(10) LAWRENCE HOLEN
DOCTOR
 40.00         X   358,694 0 17,260
(11) DR MORGAN
OR DOCTOR
 40.00         X   353,422 0 11,935
(12) MICHAEL OGBOH
CLINIC PHYSI
 40.00         X   263,413 0 18,663
(13) DR GALARNEAU
DOCTOR
 40.00         X   260,304 0 18,971
(14) JODY BOVENSCHE
CRNA
 40.00         X   239,873 0 18,072






Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,693,707   93,845
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet12
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
PHARMACY SYSTEMS INC
PO BOX 71-0716
COLUMBUS,OH43271 		PHARMACY MGT 415,501
DR LISA LEWIS
29746 BRIARTON STREET
FARMINGTON HILLS,MI483312248 		ER DOCTOR 186,975
AUTUMNWOOD OF DECKERVILLE
3387 ELLA STREET
DECKERVILLE,MI48427 		LONG TERM CARE 164,487
DR JEFFERY SMARSE
81 AVERY STREET
MT CLEMENS,MI48443 		ER DOCTOR 140,714
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet50
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 37,460
f All other contributions, gifts, grants, and
similar amounts not included above1f 		361,572
g Noncash contributions included in lines 1a-1f:$ 195,896
h Total. Add lines 1a-1f.......MediumBullet 399,032
Program Service Revenue Business Code
2a PATIENT SERVICE REVENUE   55,382,757     55,382,757
b CHARITY CARE & BAD DEBT   -2,046,842     -2,046,842
c CONTRACTUAL ADJUSTMENTS   -20,774,975     -20,774,975
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 32,560,940
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 71,241     71,241
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 684,356  
b Less: rental expenses 685,683  
c Rental income or (loss) -1,327  
d Net rental income or (loss).......MediumBullet -1,327     -1,327
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 12,932  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 12,932  
d Net gain or (loss)..........MediumBullet 12,932 12,932    
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a 19,855
b Less: direct expenses ...b 6,376
c Net income or (loss) from fundraising events..MediumBullet 13,479    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a MEALS SERVED   124,119     124,119
b MISCELLANEOUS   75,724     75,724
c PURCHASE DISCOUNTS   72,876     72,876
d All other revenue .... 12,088     12,088
e Total. Add lines 11a–11d ......MediumBullet 284,807
12 Total revenue. See Instructions....MediumBullet 33,341,104 12,932   32,915,661
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees ....        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 15,306,386 13,796,696 1,418,922 90,768
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 271,853 245,040 25,201 1,612
9 Other employee benefits ....... 2,681,479 2,366,086 309,284 6,109
10 Payroll taxes ........... 1,115,077 1,008,360 98,851 7,866
11 Fees for services (non-employees):        
a Management ...... 7,200   7,200  
b Legal ......... 98,656   98,656  
c Accounting ........... 40,300   40,300  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 3,181,519 2,720,802 460,237 480
12 Advertising and promotion .... 183,712 28,223 153,162 2,327
13 Office expenses ....... 4,028,781 3,843,553 168,761 16,467
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 588,273 585,366 2,907  
17 Travel ............ 217,906 196,225 21,280 401
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 159,986 159,986    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 1,770,919 1,584,961 183,847 2,111
23 Insurance .............. 576,542 502,120 73,266 1,156
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a TAXES & LICENSES 733,912 36,232 697,680  
b REPAIRS & MAINTANCE 443,824 440,568 3,256  
c FURNITURE & FIXTURES NON- 404,486 367,901 36,445 140
d OUTSIDE LAB 212,726 212,726    
e PROFESSIONAL FEES 156,987 156,987    
f All other expenses 482,799 188,383 289,581 4,835
25 Total functional expenses. Add lines 1 through 24f 32,663,323 28,440,215 4,088,836 134,272
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 6,916,651 2 6,822,665
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 6,312,476 4 6,712,663
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 290,947 8 292,503
9 Prepaid expenses and deferred charges ............ 268,717 9 295,344
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 41,750,985
b Less: accumulated depreciation. ..... 10b 19,875,688 21,023,573 10c 21,875,297
11 Investments—publicly traded securities .......... 3,976,362 11 3,229,994
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 200,318 15 196,818
16 Total assets. Add lines 1 through 15 (must equal line 34)... 38,989,044 16 39,425,284
Liabilities 17 Accounts payable and accrued expenses . 668,803 17 1,054,305
18 Grants payable ..........   18  
19 Deferred revenue .......... 4,467,052 19 4,084,162
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 10,385,000 23 9,955,000
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 2,832,896 25 3,051,698
26 Total liabilities. Add lines 17 through 25..... 18,353,751 26 18,145,165
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 19,836,544 27 19,976,951
28 Temporarily restricted net assets ..... 753,028 28 1,257,447
29 Permanently restricted net assets ..... 45,721 29 45,721
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 20,635,293 33 21,280,119
34 Total liabilities and net assets/fund balances ..... 38,989,044 34 39,425,284
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
33,341,104
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
32,663,323
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
677,781
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
20,635,293
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-32,955
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
21,280,119
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
MARLETTE REGIONAL HOSPITAL
  		Employer identification number

38-1507302
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
MARLETTE REGIONAL HOSPITAL
  		Employer identification number

38-1507302
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
MARLETTE REGIONAL HOSPITAL
  		Employer identification number

38-1507302
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
No
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 599,658   599,658
b Buildings ................ 23,607,211   8,477,985 15,129,226
c Leasehold improvements ............ 833,131   616,965 216,166
d Equipment ................ 16,690,905   10,780,738 5,910,167
e Other ................. 20,080     20,080
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 21,875,297
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
ACCRUED OTHER 1,763,284
ACCRUED SALARIES 800,702
ACCRUED PAID HOURS OFF 400,561
ACCRUED PAYROLL TAXES 87,151





Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 3,051,698
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 33,341,104
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 32,663,323
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 677,781
4 Net unrealized gains (losses) on investments .......................... 4 -32,955
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -32,955
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 644,826
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 35,058,180
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -32,955
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 1,750,031
e Add lines 2a through 2d ..................... 2e 1,717,076
3 Subtract line 2e from line 1..................... 3 33,341,104
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 33,341,104
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 34,413,354
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 1,750,031
e Add lines 2a through 2d...................... 2e 1,750,031
3 Subtract line 2e from line 1..................... 3 32,663,323
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 32,663,323
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 PROVISION FOR BAD DEBTS 1,750,031 BAD DEBTS (NETTED WITH REVENUE) -1,750,031
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D PROVISION FOR BAD DEBTS 1,750,031
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D BAD DEBTS (NETTED WITH REVENUE) 1,750,031
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

MRH GOLF OUTING
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

  
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 19,855     19,855
2 Less: Charitable
contributions . . . 		       
3 Gross income (line 1
minus line 2) . . . 		19,855     19,855
VerticalDirectExpenses 4 Cash prizes . . . 100     100
5 Non-cash prizes . .        
6 Rent/facility costs . . 2,439     2,439
7 Food and beverages . . 1,947     1,947
8 Entertainment . . . 1,890     1,890
9 Other direct expenses .        
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 6,376
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 13,479
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities: MI
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
Yes
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
 
No
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		1   170,521   170,521 0.500 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		1   5,815,988 3,644,272 2,171,716 6.310 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		2   5,986,509 3,644,272 2,342,237 6.810 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		454 26,659 93,037 5,387 87,650 0.250 %
f Health professions education
(from Worksheet 5) .. 		34 34 8,556   8,556 0.020 %
g Subsidized health services
(from Worksheet 6) .. 		7 28,295 3,559,802 2,413,559 1,146,243 3.330 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		56 1,418 4,127   4,127 0.010 %
jTotal Other Benefits ... 551 56,406 3,665,522 2,418,946 1,246,576 3.610 %
kTotal. Add lines 7d and 7j. .. 553 56,406 9,652,031 6,063,218 3,588,813 10.420 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 3 670 2,046   2,046 0.010 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development 26 95 1,984   1,984 0.010 %
9 Other            
10 Total 29 765 4,030   4,030 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
1,017,409
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
9,210,836
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,232,062
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-21,226
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
 
No
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
 
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1THUMB MRI CENTER LLC
  		MAGNETIC REASONANCE IMAGING (MRI) 10.000 %    
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MARLETTE REGIONAL HOSPITAL
2770 MAIN ST PO BOX 307
MARLETTE,MI484530307 		X X     X   X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:MARLETTE REGIONAL HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1   No
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 200.0%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14   No
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 BAD DEBTS ARE ESTIMATED BY THE USE OF THE ALLOWANCE METHOD BAD DEBTS FOR THE YEARS ENDED JUNE 30 2011 AND 2010 AMOUNTED TO 2150290 AND 2349317 RESPECTIVELY THE BAD DEBT EXPENSE ON LINE 2 OF SECTION A IS DETERMINED USING COST BASED UPON THE COST TO CHARGE THAT IS DEVELOPED IN SCHEDULE H RATIONALE FOR INCLUDING A PORTION OF BAD DEBT EXPENSE AS A COMMUNITY BENEFIT A PORTION OF THE ACCOUNTS WRITTEN OFF AS BAD DEBTS WOULD HAVE QUALIFIED FOR CHARITY CARE IF AN APPLICATION HAD BEEN COMPLETED AND ACCEPTED BY THE FACILITY EMERGENCY SERVICES WHICH REPRESENTS A SIGNIFICANT PORTION OF THE BAD DEBTS ARE RENDERED WITHOUT THE CONSIDERATION OF THE PATIENTS ABILITY TO PAY AS A RESULT THESE BAD DEBTS SHOULD BE CONSIDERED A PART OF PROVIDING COMMUNITY BENEFIT CHARITY CARE THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT A CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE
MEDICARE EXPLANATION PART III LINE 8 THE HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL UNDER MEDICARE REGULATIONS CRITICAL ACCESS HOSPITALS RECEIVE COST REIMBURSEMENT FOR ACUTECARE INPATIENT AND SUBSTANTIALLY ALL OUTPATIENT SERVICES THERE ARE A FEW SERVICES THAT ARE NOT PAID ON A COST REIMBURSEMENT BASIS AND THOSE SERVICES PROVIDED A SHORT FALL OF 21226
COLLECTION PRACTICES EXPLANATION PART III LINE 9B ONCE AN ACCOUNT HAS REACHED THE END OF INTERNAL COLLECTION PROCESS IT IS TURNED OVER TO AN OUTSIDE COLLECTION AGENCY BAD DEBTS RECOVERIES AMOUNTED TO 400259 FOR THE YEAR ENDED JUNE 30 2011 AND 304047 FOR THE YEAR ENDED JUNE 30 2010
NEEDS ASSESSMENT PART VI IN THE SPRING OF 2010 QHR CONDUCTED A COMMUNITYWIDE SURVEY THAT WE USED IN STRATEGIC PLANNING PHYSICIANS EMPLOYEES VOLUNTEERS AND THE GENERAL PUBLIC WERE ALL PROVIDED AN OPPORTUNITY TO RESPOND IN ADDITION TO THIS WE HOLD ONE TO TWO MEETINGS EVERY YEAR WITH OUR CORPORATE BOARD THAT IS COMPRISED OF OVER 100 MEMBERS FROM ALL COMMUNITIES WE SERVE THESE MEETINGS ALLOW THE COMMUNITY TO GIVE THEIR INPUT FOR SERVICE EXPANSIONS AND IDENTIFICATION OF HEALTH NEEDS
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI FOR INPATIENT ADMISSIONS WE SEEK ANY INFORMATION REGARDING INSURANCE COVERAGE IF NO COVERAGE IS AVAILABLE WE REFER THE PATIENT TO OUR SOCIAL WORKER WHO HELPS THE PATIENT APPLY FOR GOVERNMENT ASSISTANCE IF APPLICABLE AND AVAILABLE AND IF IT IS NOT THEN WE HELP THEM COMPLETE THE CHARITY CARE APPLICATION FOR OUTPATIENT SERVICES THE BILLING DEPARTMENT COUNSELS AND ASSISTS THE PATIENT IN APPLYING FOR GOVERNMENTAL ASSISTANCE IF NOT APPLICABLE OR AVAILABLE THE PATIENT IS ASSISTED IN COMPLETING THE CHARITY CARE APPLICATION AND APPLICATIONS TO SPECIAL ORGANIZATIONS THAT MIGHT OFFER ASSISTANCE AS WELL
COMMUNITY INFORMATION PART VI MARLETTE REGIONAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN MARLETTE WITHIN SANILAC COUNTY AREA OF SERVICE INCLUDES THE SOUTHERN PORTION OF HURON COUNTY THE EASTERN PORTION OF TUSCOLA COUNTY THE NORTHERN PORTION OF LAPEER COUNTY AND SANILAC COUNTY THE TOTAL POPULATION FOR THESE COUNTIES WAS APPROXIMATELY 222919 IN 2009 UNEMPLOYMENT FOR THESE COUNTIES RANGED AT 132 TO 190 IN 2009 AND THE PERCENTAGE OF UNINSURED IN THESE COUNTIES RANGED AT 163 TO 181 IN SEPT 2009 MEDIAN HOUSEHOLD INCOME FOR THIS AREA IN 2008 RANGED BETWEEN 38521 AND 54243
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI THE HOSPITAL IS GOVERNED BY A COMMUNITY BOARD AND HAS AN OPEN MEDICAL STAFF IT ALSO PARTICIPATES IN FREE OR REDUCED HEALTH SCREENINGS AND FAIRS THAT ARE AVAILABLE TO THE GENERAL PUBLIC REGARDLESS IF THE PATIENT IS A PATIENT IN OUR HEALTH SYSTEM
MARLETTE REGIONAL HOSPITAL LINE NUMBER 1 PART V LINE 11H PART V LINE 11H NUMBER OF RESIDENTS IN HOUSEHOLD
MARLETTE REGIONAL HOSPITAL LINE NUMBER 1 PART V LINE 13G PART V LINE 13G THE SOCIAL SERVICES DEPARTMENT WILL REVIEW AND DISCUSS THE CHARITY CARE PROGRAM WITH UNINSURED PATIENTS THAT ARE ADMITTED TO THE HOSPITAL
MARLETTE REGIONAL HOSPITAL LINE NUMBER 1 PART V LINE 19D PART V LINE 19D INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE WERE BILLED AT STANDARD HOSPITAL RATES FOR THE SERVICES PROVIDED
MARLETTE REGIONAL HOSPITAL LINE NUMBER 1 PART V LINE 21 PART V LINE 21 ALL PATIENT SERVICES ARE CHARGED AND BILLED AT THE GROSS CHARGE LEVEL
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) DAN BABCOCK (i)
(ii)		 208,179
  		 
  		9,822
  		3,139
  		5,805
  		226,945
  		 
 
(2) LAWRENCE HOLEN (i)
(ii)		 357,704
  		 
  		990
  		5,325
  		11,935
  		375,954
  		 
 
(3) DR MORGAN (i)
(ii)		 346,539
  		 
  		6,883
  		 
  		11,935
  		365,357
  		 
 
(4) MICHAEL OGBOH (i)
(ii)		 253,306
  		 
  		10,107
  		4,455
  		14,208
  		282,076
  		 
 
(5) DR GALARNEAU (i)
(ii)		 249,159
  		 
  		11,145
  		4,763
  		14,208
  		279,275
  		 
 
(6) JODY BOVENSCHE (i)
(ii)		 234,455
  		 
  		5,418
  		4,614
  		13,458
  		257,945
  		 
 










Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 1 195,896  
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MARLETTE REGIONAL HOSPITAL
 
Employer identification number

38-1507302
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION TO PROVIDE MEDICAL AND SURGICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MRH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY'S HEALTH STATUS WILL BE CONSIDERED WHERE THE NEED AND/OR THE INDIVIDUAL'S INABILITY TO PAY CO-EXIST. THESE ACTIVITIES INCLUDE ACUTE, EMERGENCY AND OUTPATIENT SERVICES IN ADDITION TO WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.
FIRST ACHIEVEMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A ACCOUNTS TOTALED OVER 2,150,290 IN FY 11. OTHER COMMUNITY BENEFITS ARE PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED ON ACTIVITIES AND SERVICES THAT MRH BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. A SAMPLING OF THESE COMMUNITY BENEFITS IS PROVIDED BELOW: EDUCATIONAL SERVICES/PROGRAMS "ABUSE AND NEGLECT RECOGNITION TRAINING FOR COMMUNITY AND HOSPITAL STAFF "CAREER GUIDANCE FOR AREA SCHOOL STUDENTS "COOPERATIVE PROFESSIONAL TRAINING WITH LOCAL COLLEGES "CPR TRAINING FOR THE COMMUNITY AND PUBLIC SAFETY AGENCIES "DISEASE/CONDITION-SPECIFIC EDUCATION, E.G., DIABETES "EDUCATION/COUNSELING FOR FAMILIES OF PATIENTS "EDUCATION/COUNSELING FOR PATIENTS "EDUCATIONAL PROGRAMS FOR EMPLOYEES (ADULT EDUCATION) "ORGAN DONATION INFORMATION CAMPAIGNS "RESOURCE LIBRARY "SCHOOL HEALTH PROGRAMS "SPEAKERS BUREAU "SUPPORT GROUPS FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY "TRAINING OF PUBLIC HEALTH AND SAFETY PERSONNEL "SAFE DRIVING PROGRAMS FOR ELDERLY DRIVERS HEALTH PROMOTION AND PREVENTIONS ACTIVITIES "BLOOD PRESSURE CLINICS "DISCHARGE PLANNING WITH FOLLOW-UP SUPPORT PROGRAMS "DRUG REVIEW FOR SENIOR CITIZENS "HEALTH PROMOTION/WELLNESS PROGRAMS "HEALTH SCREENING/HEALTH FAIRS "HOME SAFETY AND FIRST AID "NUTRITION AND WEIGHT CONTROL "RURAL HEALTH OUTREACH SERVICES "SMOKING CESSATION CLINICS "STRESS MANAGEMENT "WORK SITE HEALTH PROMOTION SERVICE EMERGENCY SERVICES/PROGRAMS "EMERGENCY SERVICES DEPARTMENT "ADVANCED LIFE SUPPORT AMBULANCE SERVICE "CRISIS INTERVENTION "FIRE AND POLICE ASSISTANCE "HELICOPTER TRANSFER ASSISTANCE CLINICAL SERVICES "CERTIFIED RURAL HEALTH CLINICS "CHILDHOOD IMMUNIZATIONS "PRIMARY CARE SERVICES "ACUTE MEDICAL AND SURGICAL SERVICES "RESIDENTIAL AND HOME-BASED HOSPICE SERVICES "UNIQUELY-ACCREDITED HOSPITAL, LABORATORY, CARDIOPULMONARY, AND LONG-TERM CARE SERVICES "MOBILE PET AND BONE DENSITY TESTING TECHNOLOGY "COORDINATION OF PATIENT CARE SERVICES IN HOSPITAL "FREE OR LOW COST SERVICES TO LOW INCOME FAMILIES "GENERAL HEALTH SCREENING CLINICS "RESPIRATORY/PULMONARY DISEASE SERVICES "SCHOOL HEALTH CLINICS (PRIMARY CARE) "SCHOOL SPORTS PHYSICALS "SKILLED NURSING SERVICES/INTERMEDIATE CARE FACILITY NON-CLINICAL HOSPITAL SERVICES "ADVOCACY ON BEHALF OF SPECIFIC PATIENTS NEEDING INTERVENTION WITH PUBLIC AGENCIES (SOCIAL SERVICES) "FREE MEETING ROOMS FOR COMMUNITY GROUPS "FREE OR LOW COST MEALS "GUIDANCE AND REFERRAL TO COMMUNITY SERVICES AND PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICAID "MEALS FOR FAMILY MEMBERS "TRANSLATION OR INTERPRETER SERVICES FOR NON-ENGLISH SPEAKING PATIENTS SUPPORT FOR OTHER HEALTH CARE PROVIDERS "RADIATION AND CHEMOTHERAPY SERVICES "VISITING MEDICAL AND SURGICAL SPECIALISTS TO COMPLEMENT PRIMARY CARE PHYSICIANS' CARE "SUPPORT FOR BLOOD DRIVES "DONATION OF USED EQUIPMENT TO OTHER PROVIDERS "PHYSICIAN REFERRAL SERVICES "PARTNER IN REGIONAL RURAL HEALTH NETWORKS WORKING RELATIONSHIP WITH OTHERS "CIVIC ORGANIZATIONS SUCH AS LIONS CLUB AND TOYS FOR TOTS "AMERICAN ASSOCIATION OF RETIRED PERSONS "COMMUNITY-BASED BUSINESS GROUPS SUCH AS CHAMBERS OF COMMERCE "ECONOMIC DEVELOPMENT AGENCIES "HOME HEALTH AGENCIES "HOSPICES "LOCAL SCHOOLS AND COLLEGES "MENTAL HEALTH CENTERS "NURSING HOMES "SENIOR CITIZENS ORGANIZATIONS "STATE AND LOCAL AGENCIES AND ORGANIZATIONS MARLETTE REGIONAL HOSPITAL IS COMMITTED TO SERVING OUR PATIENTS IN WAYS THAT RESPECT THE ORIGINAL VALUES OF OUR COMMUNITY - A COMPASSION FOR OUR NEIGHBORS AND A SENSE OF DUTY TO SERVE THOSE IN NEED. IN RESPECTING THESE VALUES, MARLETTE REGIONAL HOSPITAL ACKNOWLEDGES ITS OBLIGATION TO OFFER SERVICES TO PATIENTS THAT MAY NOT BE ABLE TO FULLY AFFORD THE CARE THEY NEED, WHILE ALSO SERVING THE HEALTH IMPROVEMENT NEEDS OF OUR LARGER COMMUNITY. TO THAT END, THE HOSPITAL HAS ADOPTED POLICIES THAT DESCRIBE HOW SERVICES ARE DISCOUNTED AND HOW CHARITY CARE IS DETERMINED AND OFFERED.
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MEMBERS
ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A MEMBERS MAY BE NOMINATED AT THE ANNUAL MEETING OF MEMBERS EITHER BY THE BOARD OF TRUSTEES OR BY ANY INDIVIDUAL MEMBER. MEMBERS SHALL BE ELECTED TO THREE-YEAR TERMS. THE MEMBERS' TERMS SHALL BE ARRANGED (AS NEAR AS POSSIBLE) SO THAT THE TERMS OF ONE-THIRD OF THE CORPORATION'S MEMBERS SHALL EXPIRE IMMEDIATELY FOLLOWING EACH ANNUAL MEETING OF THE CORPORATION'S MEMBERS. AT EACH ANNUAL MEETING, THE MEMBERS THEN IN OFFICE SHALL RE-ELECT MEMBERS WHOSE TERMS ARE EXPIRING AND/OR ELECT NEW MEMBERS TO THE CORPORATION.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B EACH MEMBER OF THE CORPORATION IN GOOD STANDING SHALL BE QUALIFIED TO CAST ONE VOTE ON ANY ISSUE THAT MAY PROPERLY COME BEFORE ANY MEETING OF THE CORPORATION'S MEMBERS. VOTING BY PROXY OR ABSENTEE BALLOT SHALL NOT BE PERMITTED UNLESS IS SPECIFICALLY AUTHORIZED BY A MAJORITY VOTE OF THE MEMBERS PRESENT AT THE MEETING.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE 990 WILL BE REVIEWED AND APPROVED AT A REGULAR BOARD MEETING.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL IS BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS. IN ADDITION THE COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ANNUALLY.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION OF OTHER TOP OFFICIALS ARE BASED UPON APPLICABLE STATEWIDE COMPENSATION SURVEYS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, ADMINISTRATIVE POLICIES, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC.
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 NET UNREALIZED GAINS ON INVESTMENTS
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

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