TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Margaret Coleman Chair	0.50 .......................0	X	X	0	0	0
(2) Brad Johnson CPA Vice Chair	0.50 .......................0	X	X	0	0	0
(3) Jeff Weiden Treasurer	0.50 .......................0	X	X	0	0	0
(4) David Baum Secretary	0.50 .......................0	X	X	0	0	0
(5) Sheryl Lewis-Blake President	40.00 .......................0	X	X	328,826	0	52,282
(6) Marc Chircop Director	0.50 .......................49.50	X		0	636,998	209,693
(7) David Ottenbaker MD Director	0.50 .......................49.50	X		0	427,460	41,021
(8) Nancy Goodin Director	0.50 .......................0	X		0	0	0
(9) Dan King Director	0.50 .......................0	X		0	0	0
(10) Christopher Noah MD Director	0.50 .......................0	X		6,480	0	0
(11) Kimberly Norris MD Director	0.50 .......................0	X		0	0	0
(12) Nathan Tagg Director	0.50 .......................0	X		0	0	0
(13) Sam Watson Director	0.50 .......................0	X		0	0	0
(14) Connie Downs CFO	40.00 .......................0		X	196,015	0	34,112
(15) Douglas Smendik CMO	40.00 .......................0		X	40,530	0	0
(16) Carla Wilson-Neil COO	40.00 .......................0		X	181,213	0	15,853
(17) Steve Marzolf CNO	40.00 .......................0		X	152,151	0	43,398

(A) Name and business address	(B) Description of services	(C) Compensation
Progressive Building Services Inc PO Box 88235 Kentwood,MI49518	House Keeping Services	757,701
Hastings Anesthesiology PC PO Box 4095 Kalamazoo,MI49003	Anasthesia Services	467,600
Spectrum Health 100 Michigan Grand Rapids,MI49503	Reference Lab / Sleep Study	433,078
HDR Architecture Inc PO Box 3480 Omaha,NE68103	Architectural Services	311,367
Aramark Corporation 10510 Twin Lakes Parkway Charlotte,NC28269	Repair Services	291,176
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 10

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 domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....	1,363,701	1,240,968	122,733
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 ....	23,709,188	15,410,972	8,298,216
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,072,070	750,449	321,621
9	Other employee benefits .......	2,128,578	1,489,965	638,613
10	Payroll taxes ...........	1,607,338	1,125,137	482,201
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	426,621	426,621
c	Accounting ...........	112,250		112,250
d	Lobbying ...........	4,802		4,802
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	156,649		156,649
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	7,210,588	4,186,888	3,023,700	0
12	Advertising and promotion ....	64,895	16,224	48,671
13	Office expenses .......	1,037,975	801,188	236,787
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	1,437,621	1,073,743	363,878
17	Travel ............	315,587	205,132	110,455
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	247,126	247,126
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	2,261,887	1,922,604	339,283
23	Insurance ..............	248,129	161,284	86,845
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	8,068,950	7,559,447	509,503
b	Bad Debts	3,770,801	3,770,801
c	Quality Assurance Assessments	924,447		924,447
d	Maintenance and Repairs	934,222	781,532	152,690
e	All other expenses	2,029	2,029	0	0
25	Total functional expenses. Add lines 1 through 24e	57,105,454	41,172,110	15,933,344	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	130,511	1	72,861
2	Savings and temporary cash investments .........	6,293,541	2	3,475,833
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	8,453,773	4	8,255,966
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		56,500	5	17,833
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............	6,092,948	7	5,029,388
8	Inventories for sale or use ..............	998,923	8	1,014,463
9	Prepaid expenses and deferred charges ..........	559,292	9	598,407
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	47,143,077
b	Less: accumulated depreciation .....	10b	31,634,700	24,736,525	10c	15,508,377
11	Investments—publicly traded securities ..........	59,400,385	11	64,130,064
12	Investments—other securities. See Part IV, line 11 .....	0	12
13	Investments—program-related. See Part IV, line 11 .....	0	13
14	Intangible assets ...............	630,000	14	0
15	Other assets. See Part IV, line 11 ...........	969,828	15	1,561,518
16	Total assets. Add lines 1 through 15 (must equal line 34)......	108,322,226	16	99,664,710
	17	Accounts payable and accrued expenses .........	5,850,607	17	7,193,195
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	11,930,362	20	10,743,760
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other 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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	1,514,635	25	1,873,130
26	Total liabilities. Add lines 17 through 25.........	19,295,604	26	19,810,085
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	88,207,439	27	78,378,249
28	Temporarily restricted net assets ...........	819,183	28	1,022,060
29	Permanently restricted net assets ...........		29	454,316
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	89,026,622	33	79,854,625
34	Total liabilities and net assets/fund balances ........	108,322,226	34	99,664,710

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

4,802

Total. Add lines 1c through 1i ...............................

4,802

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	A portion of dues paid to MHA and AHA are allocated to Lobbying activities.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

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 value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

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 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	3,703,430		3,703,430
b	Buildings ................	25,229,313	19,638,178	5,591,135
c	Leasehold improvements ............	1,745,888	1,093,582	652,306
d	Equipment ................	15,646,946	10,902,940	4,744,006
e	Other .................	817,500		817,500
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				15,508,377

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Third Party Payor Settlements		1,873,130








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		1,873,130
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2014

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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 XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
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 XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 25000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance 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	Financial Assistance at cost (from Worksheet 1) ..	0	0	217,206	0	217,206	0.41 %
b	Medicaid (from Worksheet 3, column a) ....	0		5,584,869	3,765,855	1,819,014	3.41 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .	0		1,276	181,854	-180,578	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	0	5,803,351	3,947,709	1,855,642	3.82 %
Other Benefits		86	1,398	17,658	0	17,658	0.03 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	86	1,398	17,658	0	17,658	0.03 %
f	Health professions education (from Worksheet 5) ..	0	0	0	0	0	0 %
g	Subsidized health services (from Worksheet 6) ..			0	0	0	0 %
h	Research (from Worksheet 7)			0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	52	4,328	15,915	0	15,915	0.03 %
j	Total. Other Benefits ..	138	5,726	33,573	0	33,573	0.06 %
k	Total. Add lines 7d and 7j .	138	5,726	5,836,924	3,947,709	1,889,215	3.88 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(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		155,960		155,960	0.29 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members	1		208		208	0 %
6	Coalition building	35	657	21,749		21,749	0.04 %
7	Community health improvement advocacy	7	151	3,948		3,948	0.01 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	45	808	181,865	0	181,865	0.34 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,770,801

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

53,293

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

7,731,946

Enter Medicare allowable costs of care relating to payments on line 5.....

6,949,535

Subtract line 6 from line 5. This is the surplus (or shortfall)........

782,411

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1BARRY HEALTH PARTNERS LTD	See Part VI	50 %	50 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	PENNOCK HOSPITAL 1009 W GREEN ST HASTINGS,MI49058 www.pennockhealth.com; 1060000022	X	X	X

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	PENNOCK HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.pennockhealth.com/bhealthy/site/health_assessment.html

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): http://www.pennockhealth.com/bhealthy/site/health_assessment.html

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	PENNOCK HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 2.5%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): HTTP://WWW.SPECTRUMHEALTH.ORG/FINANCIALASSISTANCE

The FAP application form was widely available on a website (list url): HTTP://WWW.SPECTRUMHEALTH.ORG/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.SPECTRUMHEALTH.ORG/FINANCIALASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	PENNOCK HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ................................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - PENNOCK HOSPITAL. Pennock Hospital assesses the health care needs of the communities we serve utilizing internal data, data collected from Thompson Reuters, Michigan Health and hospital association, Barry Eaton Health department, local social services agencies, school systems, national health associations (American Cancer Society, American Heart Association, American Diabetes Association, March of Dimes), and our payors. Pennock collects data internally based on inpatient and outpatient statistics. Thompson Reueters provides data regarding the services being used by the population within the service area supported by Pennock Hospital, including projected population growth trends by age and sex. This helps us to examine the patient needs at a closer level. Local social services agencies and school systems help us identify socioeconomic factors contributing to the identified health status of our service area. The National Health Associations provide data as related to their disease specific area for our county. The composition of the CHNA Steering Committee was such that it was a broad-based representation from the community, including the most vulnerable and lower socio-economic status.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Pennock Hospital. Barry Eaton District Health Department
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - PENNOCK HOSPITAL. THROUGH THE WORKGROUP MEMBERS AND THEIR RELATED AGENCIES.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Pennock Hospital. THE LEADING CAUSES OF DEATH IN BARRY COUNTY ARE CANCER, HEART DISEASE, DIABETES-RELATED, CHRONIC LOWER RESPIRATORY, STROKE, ALZHEIMERS DISEASE, UNINTENTIONAL INJURY, PNEMONIA & INFLUENZA, INTENTIONAL SELF-HARM (SUICIDE), KIDNEY DISEASE, CHRONIC LIVER DISEASE, INFANT MORTALITY, SEPTICEMIA, ALCOHOL-INDUCED, AIDS, AND ASSAULT (HOMICIDE). DISEASE STATE OR CAUSE OF DEATH WERE NOT CHOSEN BECAUSE OF THE FOCUS ON PREVENTION OF CHRONIC DISEASE THROUGH CHANGING BEHAVIORS AND PREVENTING ILLNESS. ADDITIONALLY, PENNOCK HEALTH SERVICES EXPANDED NEPHROLOGY, OFFERS DIABETIC EDUCATION AND HEALTH COACHES TO ADDRESS HEALTH BEHAVIORS AND MANAGEMENT, AND ALL PENNOCK PHYSICIAN NETWORK CLINICS AND MOST OF THE PHYSICIAN OFFICES ARE PATIENT CENTERED MEDICAL HOME (PCMH) DESIGNATED WHERE THEY HAVE A STRONG FOCUS ON PREVENTION AND DISEASE MANAGEMENT. IN 2012, PENNOCK BROUGHT DIALYSIS SERVICES TO BARRY COUNTY. PENNOCK IS EXPANDING HEART AND VASCULAR SERVICES, AND HAS A STRATEGIC INITIATIVE ALREADY IN PLACE TO EXPAND CANCER SERVICES. TOBACCO USE REDUCTION HAS A COALITION WORKING ON THIS INITIATIVE; THE STEERING COMMITTEE FELT IT NEEDED A STRONGER PARTNERSHIP WITH PENNOCK. BARRY SUBSTANCE ABUSE TASKFORCE ADDRESSES ALCOHOL AND DRUG USE. PENNOCK AIDS IN AWARENESS AND THE PENNOCK FOUNDATION PROVIDES SOME FUNDING. IN ADDITION, A GROUP HAS FORMED TO REDUCE SUICIDE. PENNOCK AND THE PENNOCK FOUNDATION ASSIST WITH RESOURCE AWARENESS AND FUNDING.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - PENNOCK HOSPITAL. THE ORGANIZATION USES FPG TO DETERMINE ELIGIBILITY FOR FREE CARE. AN EVALUATION IS NOT USED FOR DISCOUNTED CARE, AS APPLICANTS THAT QUALIFY FOR ANY ASSISTANCE RECEIVE FREE CARE.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - PENNOCK HOSPITAL. PENNOCK HOSPITAL HAS IMPLEMENTED MEASURES TO WIDELY PUBLICIZE COMMUNICATIONS TO PATIENTS AND THE PUBLIC REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. COMMUNICATION METHODS INCLUDE BUT ARE NOT LIMITED TO SIGNAGE IN EACH HOSPITAL EMERGENCY DEPARTMENT, ADMISSIONS OFFICE(S) AND OTHER PUBLIC LOCATIONS, INFORMATION ON THE PENNOCK HOSPITAL WEBSITE, THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL RESOURCE ADVISORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, PENNOCK HOSPITAL WILL OFFER A PLAIN LANGUAGE SUMMARY OF ITS FINANCIAL ASSISTANCE ELIGIBILITY POLICY AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS, AS WELL AS PROVIDE INDIVIDUALS WITH ASSISTANCE IN COMPLETING THE APPLICATION PROCESS. PATIENTS WILL BE NOTIFIED OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY FOR A PERIOD OF AT LEAST 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. PATIENT BALANCES WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE EVALUATION FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT ("APPLICATION PERIOD"). IF PENNOCK HOSPITAL RECEIVES A FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD, WHETHER THE APPLICATION IS COMPLETE OR INCOMPLETE, IT WILL SUSPEND ANY COLLECTION EFFORTS UNTIL A DETERMINATION REGARDING FINANCIAL ASSISTANCE IS MADE.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - PENNOCK HOSPITAL. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE PROVIDED FREE CARE, THEREFORE THE ORGANIZATION DOES NOT CHARGE ANY AMOUNT TO THOSE PATIENTS.

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?14
Name and address		Type of Facility (describe)
1	STATE STREET URGENT CARE CENTER 1108 W STATE STREET HASTINGS,MI49058	URGENT CARE CENTER
2	PENNOCK HOME HEALTH 1230 W STATE STREET HASTINGS,MI49058	HOME HEALTH CARE AGENCY
3	HASTINGS GENERAL SURGEONS 1009 W STATE STREET HASTINGS,MI49058	SURGEON PRACTICE OFFICE
4	GUN LAKE FAMILY MEDICINE 77 124TH AVE SHELBYVILLE,MI49344	FAMILY PRACTICE OFFICE
5	PENNOCK HOSPICE 1230 W STATE STREET HASTINGS,MI49058	OUTPATIENT HOSPICE CARE
6	CLARKSVILLE FAMILY MEDICINE 155 E CROSS ST CLARKSVILLE,MI48815	FAMILY PRACTICE OFFICE
7	CALEDONIA FAMILY MEDICINE 9090 RODGERS CT CALEDONIA,MI49316	FAMILY PRACTICE OFFICE
8	HASTINGS FAMILY MEDICINE 1009 W STATE STREET HASTINGS,MI49058	FAMILY PRACTICE OFFICE
9	NASHVILLE FAMILY MEDICINE 750 DURKEE NASHVILLE,MI49073	FAMILY PRACTICE OFFICE
10	ADVANCED ORTHOPEDIC AND PAIN INSTITUTE 840 COOK RD HASTINGS,MI49058	SURGEON PRACTICE OFFICE
11	WOMEN'S HEALTH FIRST 1108 W STATE STREET HASTINGS,MI49058	OBGYN
12	LAKEWOOD FAMILY MEDICINE 4294 LAUREL DRIVE LAKE ODESSA,MI48849	FAMILY PRACTICE OFFICE
13	HOPKINS FAMILY MEDICINE 130 W MAIN STREET HOPKINS,MI49328	FAMILY PRACTICE OFFICE
14	Delton Office 11275 Sprague Rd Delton,MI49046	Family Practice Office

Schedule H (Form 990) 2014

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
Schedule H, Part IV, Column (b) DESCRIPTION OF PRIMARY ACTIVITY	NAME OF ENTITY: BARRY HEALTH PARTNERS LTD TO INTEGRATE PHYSICIAN AND HOSPITAL CLINICAL PRACTICES & PAYOR CONTRACTING.
Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT	THE STATE OF MICHIGAN DOES NOT REQUIRE A COMMUNITY BENEFIT REPORT TO BE FILED WITH THE STATE HOWEVER SPECTRUM HEALTH SYSTEM, INCLUDING PENNOCK HOSPITAL, VOLUNTARILY REPORTS CONSOLIDATED COMMUNITY BENEFIT INFORMATION TO THE MICHIGAN HEALTH AND HOSPITAL ASSOCIATION AND IN AN ANNUAL MEETING TO THE COMMUNITY. THE COMMUNITY BENEFIT REPORT IS ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	3770801
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE COST TO CHARGE RATIO WAS USED TO DETERMINE PATIENT SERVICE COSTS.
Schedule H, Part II Community Building Activities	PENNOCK HOSPITAL IS DEDICATED TO THE COMMUNITY IT SERVES. THE HOSPITAL WORKS TO ADDRESS THE PRESSING HEALTH ISSUES OF THE COMMUNITY IT SERVES BY PROMOTING AND ADVOCATING FOR OVERALL COMMUNITY HEALTH IMPROVEMENT.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE, PAYER COMPOSITION AND AGING, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYER CATEGORY AND OTHER FACTORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTED ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR THIRD PARTY PAYERS, THE PROVISION IS DETERMINED BY ANALYZING CONTRACTUALLY DUE AMOUNTS FROM PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES. FOR SELF-PAY PATIENTS, THE PROVISION IS BASED ON AN ANALYSIS OF PAST EXPERIENCE RELATED TO PATIENTS UNWILLING TO PAY STANDARD RATES CHARGED. THE DIFFERENCE BETWEEN THAT STANDARD RATE CHARGED (LESS THE NEGOTIATED DISCOUNTED RATE) AND THE AMOUNT ACTUALLY COLLECTED AFTER THE REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ALL CHARGES ARE REPORTED AT GROSS, WHICH IS CONSISTENT WITH THE REPORTING METHODOLOGY USED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	THE HOSPITAL FACILITIES ARE UNABLE TO ESTIMATE ACCURATELY THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES MAY RELATE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE, A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. THE HOSPITAL FACILITIES HAVE IMPLEMENTED A "PROPENSITY TO PAY" EVALUATION TOOL THAT PROACTIVELY ASSESSES ONE'S ABILITY AND LIKELIHOOD TO PAY. THIS TOOL HAS PROVIDED A HIGHER DEGREE OF FOCUSED FINANCIAL COUNSELING EFFORTS, RESULTING IN A SUBSTANTIAL REDUCTION OF BAD DEBT AND HIGHER RATE OF IDENTIFICATION OF CHARITY ACCOUNTS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE NET PATIENT SERVICE REVENUE, PATIENT ACCOUNTS RECEIVABLE, AND ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS FOOTNOTE IS ON PAGES 13 TO 15 OF THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	PENNOCK HOSPITAL DOES NOT EXPERIENCE A MEDICARE SHORTFALL. THE MEDICARE COST REPORT WAS USED TO REPORT MEDICARE ALLOWABLE COSTS.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE ELIGIBLE FOR FREE CARE, AND THUS NO COLLECTION ACTIONS ARE TAKEN. IF FINANCIAL ASSISTANCE ELIGIBILITY WOULD BE DISCOVERED AFTER COMMENCEMENT OF A COLLECTION ACTION, THEN SUCH COLLECTION ACTION WOULD BE SUSPENDED OR REVERSED.
Schedule H, Part V, Section B, Line 16a FAP website	- PENNOCK HOSPITAL: Line 16a URL: HTTP://WWW.SPECTRUMHEALTH.ORG/FINANCIALASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website	- PENNOCK HOSPITAL: Line 16b URL: HTTP://WWW.SPECTRUMHEALTH.ORG/FINANCIALASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- PENNOCK HOSPITAL: Line 16c URL: HTTP://WWW.SPECTRUMHEALTH.ORG/FINANCIALASSISTANCE;
Schedule H, Part VI, Line 2 Needs assessment	PENNOCK HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY UTILIZING INTERNAL DATA, DATA COLLECTED FROM THOMPSON REUTERS, MICHIGAN HEALTH AND HOSPITAL ASSOCIATION, BARRY EATON HEALTH DEPARTMENT, LOCAL SOCIAL SERVICE AGENCIES, SCHOOL SYSTEMS, NATIONAL HEALTH ASSOCIATIONS (AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES), AND OUR PAYORS. PENNOCK COLLECTS DATA INTERNALLY BASED ON INPATIENT AND OUTPATIENT STATISTICS. THOMPSON REUTERS PROVIDES DATA REGARDING THE SERVICES BEING USED BY THE POPULATION WITHIN THE SERVICE AREA SUPPORTED BY PENNOCK HOSPITAL, INCLUDING PROJECTED POPULATION GROWTH TRENDS BY AGE AND SEX. THIS HELPS US TO EXAMINE THE PATIENT NEEDS AT A CLOSER LEVEL. LOCAL SOCIAL SERVICES AGENCIES AND SCHOOL SYSTEMS HELP US IDENTIFY SOCIOECONOMIC FACTORS CONTRIBUTING TO THE IDENTIFIED HEALTH STATUS OF OUR SERVICE AREA. THE NATIONAL HEALTH ASSOCIATIONS PROVIDE DATA AS RELATED TO THEIR DISEASE SPECIFIC AREA FOR OUR COUNTY.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	PENNOCK HOSPITAL 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 THROUGH PRODUCING INFORMATION CARDS FOR THE UNINSURED, COMMUNITY OUTREACH PROGRAMS, CONSUMER INFORMATION CLASSES, PENNOCK HOSPITAL'S WEBSITE, PERSONAL FINANCIAL COUNSELING AND BY PROVIDING ASSISTANCE IN THE ACTUAL ENROLLMENT OF SUCH PROGRAMS. PENNOCK HOSPITAL HAS A DEPARTMENT OF FINANCIAL COUNSELORS WHO WORK WITH PATIENTS THAT EXPRESS ANY LEVEL OF CONCERN WITH PAYING THEIR BILL. IN ADDITION, FINANCIAL COUNSELORS PROACTIVELY IDENTIFY PATIENTS WHO HAVE QUALIFYING FACTORS FOR GOVERNMENTAL ASSISTANCE. PENNOCK HOSPITAL ALSO PARTNERS WITH ORGANIZATIONS THAT SPECIALIZE IN THE QUALIFICATION PROCESS. IF A PATIENT'S NEED FOR ASSISTANCE IS NOT IDENTIFIED PRIOR TO BILLING, ANY CONCERNS AS A RESULT OF RECEIVING A BILL ARE ADDRESSED BY FINANCIAL COUNSELORS AT THAT TIME. PENNOCK HOSPITAL WIDELY PUBLICIZES COMMUNICATIONS TO PATIENTS AND THE PUBLIC ON THE AVAILABILITY OF FINANCIAL ASSISTANCE. THIS IS ACHIEVED THROUGH VARIOUS METHODS INCLUDING, BUT NOT LIMITED TO, THE SPECTRUM HEALTH PATIENT HANDBOOK, VARIOUS INFORMATIONAL BROCHURES, SIGNAGE IN THE HOSPITAL EMERGENCY DEPARTMENT, ADMISSIONS OFFICE AND OTHER PUBLIC LOCATIONS, UPON REQUEST BY ANY PATIENT, GUARANTOR OR COMMUNITY MEMBER, WORD OF MOUTH VIA FINANCIAL COUNSELORS AND OTHERS, AND THROUGH COMMUNITY PUBLICATIONS AND OUTREACH EVENTS. IN ADDITION, PENNOCK HOSPITAL LISTS OPTIONS FOR THE UNINSURED AND UNDERINSURED ON THEIR WEBSITE, ALONG WITH A COPY OF THE FINANCIAL ASSISTANCE ELIGIBILITY POLICY (SEARCH "FINANCIAL ASSISTANCE" AT WWW.PENNOCKHOSPITAL.ORG).
Schedule H, Part VI, Line 4 Community information	BARRY COUNTY, MICHIGAN IS THE COMMUNITY PENNOCK SERVES. BARRY COUNTY BOASTS 59,173 RESIDENTS, UP 5% SINCE 2000. WITH 11.8% OF THE POPULATION OVER THE AGE OF 65, BARRY COUNTY IS A RELATIVELY YOUNG COMMUNITY. BARRY COUNTY ALSO SERVES AS A STABLE COMMUTER COMMUNITY WHERE THE AVERAGE TRAVEL TIME IS APPROXIMATELY 30 MINUTES AND THE AVERAGE HOUSEHOLD INCOME IS $46,820. BARRY COUNTY IS UNIQUELY LOCATED IN THE MIDDLE OF FOUR (4) LARGER METROPOLITAN AREAS: GRAND RAPIDS, LANSING, KALAMAZOO, AND BATTLE CREEK. Pennock Hospital is the only hospital within a 35 mile radius servicing residents of the community. Other healthcare resources available in the community include both independent and Pennock employed physician offices, the Barry Community Free Clinic, Health Connections Clinic, and Pennock Urgent Care Center.
Schedule H, Part VI, Line 5 Promotion of community health	THE BOARD OF DIRECTORS IS SUBSTANTIALLY COMPOSED OF INDEPENDENT COMMUNITY MEMBERS THAT RESIDE IN THE PRIMARY SERVICE AREA OF THE HOSPITAL. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE MISSION OF PENNOCK HOSPITAL IS TO PROVIDE QUALITY HEALTH SERVICES IN A PERSONAL, PROFESSIONAL, AND PROGRESSIVE MANNER IN PARTNERSHIP WITH OUR COMMUNITY. OUR MISSION IS CLOSELY CORRELATED WITH THE HEALTH AND SOCIOECONOMIC DATA COLLECTED. THIS DATA ALONG WITH OUR MISSION ASSISTS IN STRATEGIC PLANNING EFFORTS TO ALIGN THE SERVICES PROVIDED BY PENNOCK WITH THE TRUE COMMUNITY HEALTH NEED. SPONSORSHIPS AND DONATIONS OR VOLUNTEER TIME IS DIRECTED IN THE AREAS OF HEALTH STATUS IDENTIFICATION, EVALUATION, AND EDUCATION WHERE PREVENTION OR MANAGEMENT IS TAUGHT. PENNOCK COLLEAGUES VOLUNTEER TIME AND MATERIALS TO PROVIDE HEALTH SCREENINGS, FREE OR AT A REDUCED RATE DEPENDING ON THE SERVICE BEING PROVIDED. COLLEAGUES ALSO COLLABORATE WITH LOCAL BUSINESSES TO EDUCATE THEIR EMPLOYEES ON HEALTH IMPROVEMENT AND COST SAVINGS OPTIONS TO EMPLOYERS, WHICH HELPS THE LOCAL ECONOMY AND IMPROVES OVERALL HEALTH OF OUR WORKFORCE. FINALLY, PENNOCK PROVIDES A LOCATION FREE OF CHARGE TO HOUSE THE BARRY COMMUNITY FREE CLINIC AND HABITAT FOR HUMANITY TO ALLEVIATE OVERHEAD AND ALLOW THESE SERVICES TO ASSIST THOSE IN NEED IN OUR COUNTY.
Schedule H, Part VI, Line 6 Affiliated health care system	Spectrum Health is an integrated not-for-profit health system in West Michigan offering a full continuum of care through the Spectrum Health Hospital Group, which is comprised of twelve hospitals including Helen DeVos Children's Hospital, a state of the art children's hospital and more than 180 service sites; the Spectrum Health Medical Group physician group totaling more than 1,200 providers; and Priority Health, a health plan with 590,000 members. Spectrum Health is West Michigan's largest employer with more than 21,700 employees. The integrated health system provided $283 million in community benefit during its 2015 fiscal year. The $283 million in community benefit includes community benefit activities by the facilities included on Schedule H Hospitals as well as community benefit activities of other organization across the integrated health system. Pennock Hospital is a member of the affiliated group of entities within Spectrum Health and is responsible for creating value within its respective community. From its inception, Pennock Hospital has been a faithful steward of its community assets. As a West Michigan-based not-for-profit hospital, the organization invests its net earnings to improve patient care, build and renovate facilities, purchase new technology, provide health education and fund local community programs. Over the years, our mission has remained the same-to provide healthcare services to the citizens of Barry County in a personal, professional, and progressive manner in partnership with the community. We take our mission seriously. It is central to our strategic discussions and guides our investments and the allocation of our resources. Pennock Hospital is committed to providing value to the people we serve. "Value" means access to high-quality health care at affordable costs, as well as access to the full continuum of health care services, from health insurance to outpatient care to inpatient and home care, and everything in between. PENNOCK HOSPITAL HAS PROGRAMS THAT SUPPORT ITS MISSION "TO PROVIDE QUALITY HEALTH SERVICES IN A PERSONAL, PROFESSIONAL, AND PROGRESSIVE MANNER IN PARTNERSHIP WITH THE COMMUNITY."
Schedule H, Part VI, Line 7 State filing of community benefit report	MI

Schedule H (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

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, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Sheryl Lewis-Blake President	(i) (ii)	272,419 ............................... 0	8,241 ............................... 0	48,166 ............................... 0	13,000 ............................... 0	39,282 ............................... 0	381,108 ............................... 0	0 ............................... 0
2Marc Chircop Director	(i) (ii)	0 ............................... 367,980	0 ............................... 242,691	0 ............................... 26,327	0 ............................... 144,756	0 ............................... 64,937	0 ............................... 846,691	0 ............................... 144,187
3David Ottenbaker MD Director	(i) (ii)	0 ............................... 339,203	0 ............................... 86,723	0 ............................... 1,534	0 ............................... 23,400	0 ............................... 17,621	0 ............................... 468,481	0 ............................... 0
4Connie Downs CFO	(i) (ii)	170,825 ............................... 0	6,016 ............................... 0	19,174 ............................... 0	9,601 ............................... 0	24,511 ............................... 0	230,127 ............................... 0	0 ............................... 0
5Carla Wilson-Neil COO	(i) (ii)	157,750 ............................... 0	5,074 ............................... 0	18,389 ............................... 0	12,619 ............................... 0	3,234 ............................... 0	197,066 ............................... 0	0 ............................... 0
6Steve Marzolf CNO	(i) (ii)	135,204 ............................... 0	5,248 ............................... 0	11,699 ............................... 0	5,902 ............................... 0	37,496 ............................... 0	195,549 ............................... 0	0 ............................... 0
7Bob Davis Exec. Dir. Physican Network	(i) (ii)	138,758 ............................... 0	4,885 ............................... 0	1,093 ............................... 0	2,856 ............................... 0	24,641 ............................... 0	172,233 ............................... 0	0 ............................... 0
8James Horton MD Physician	(i) (ii)	379,224 ............................... 0	0 ............................... 0	126,366 ............................... 0	0 ............................... 0	16,403 ............................... 0	521,993 ............................... 0	0 ............................... 0
9Eric Leep MD Physician	(i) (ii)	294,563 ............................... 0	0 ............................... 0	173,461 ............................... 0	10,400 ............................... 0	21,388 ............................... 0	499,812 ............................... 0	0 ............................... 0
10David Heeringa MD Physician	(i) (ii)	319,781 ............................... 0	0 ............................... 0	46,574 ............................... 0	0 ............................... 0	21,071 ............................... 0	387,426 ............................... 0	0 ............................... 0
11Laura Doherty MD Physician	(i) (ii)	291,529 ............................... 0	264 ............................... 0	70,253 ............................... 0	4,629 ............................... 0	2,755 ............................... 0	369,430 ............................... 0	0 ............................... 0
12Max Rappaport MD Physician	(i) (ii)	289,607 ............................... 0	33,300 ............................... 0	14,734 ............................... 0	5,200 ............................... 0	37,743 ............................... 0	380,584 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference

Explanation

Schedule J, Part I, Line 1a Health or social club dues or initiation fees

THE HEALTH AND WELLNESS CENTER IS AVAILABLE TO ALL BOARD MEMBERS AND IS TREATED AS TAXABLE COMPENSATION, AND INCLUDED IN FORM W-2.

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

$144,187 Marc Chircop SCHEDULE J, PART I, LINE 4B IS ANSWERED "YES" BECAUSE CERTAIN INDIVIDUALS, DO "PARTICIPATE IN" SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN(S). SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN(S) BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR.

Schedule J (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Pennock Hospital

Employer identification number
38-1360562

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (2003 HELP Loan)	38-2889417	59465E5V1	12-10-2003	13,400,000	HEALTHCARE EQUIPMENT		X		X	X
B	MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (2006 HELP Loan)	38-2889417	59465HGG5	08-29-2007	7,500,000	HEALTHCARE EQUIPMENT		X		X	X
C	MICHIGAN FINANCE AUTHORITY (2011 HELP Loan)	80-0596186	59447PFB2	06-29-2011	5,750,000	HEALTHCARE EQUIPMENT		X		X	X
D	MICHIGAN FINANCE AUTHORITY (2013 HELP Loan)	80-0596186	59447PXP1	10-10-2013	13,700,000	HEALTHCARE EQUIPMENT		X		X	X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	3,719,587		1,994,792		690,961		862,827
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	4,300,000		3,031,165		4,171,549		6,500,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .	0		0		0		0
5 Capitalized interest from proceeds . . . . . . . . . . .	0		0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	51,122		36,037		66,804		77,278
8 Credit enhancement from proceeds . . . . . . . . . . .	0		0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	4,248,878		2,995,128		4,104,745		6,422,722
11 Other spent proceeds . . . . . . . . . . . . . .	0		0		0		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0		0
13 Year of substantial completion . . . . . . . . . . . .	2003		2008		2012		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .
b Exception to rebate? . . . . . . . .
c No rebate due? . . . . . . . .	X		X		X		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .	X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Schedule K, Part I, Column (i) Pooled Financing Arrangement	The Michigan State Hospital Finance Authority (MSHFA) was created by Act 38 of 1969, Hospital Finance Authority Act for the purpose of making loans to healthcare organizations in Michigan. MSHFA offers Healthcare Equipment Loan Program (HELP) bond issues which are pooled loans offering assistance to both large integrated health delivery systems and a broad range of smaller healthcare providers. The HELP participants share the costs of issuance and administrative fees among multiple borrowers in a single bond issue. The amounts reported on line 1(e) represent the entire bond issue, while the amounts in Part II, line 3 relate to the portion of the bonds allocated to Pennock Hospital. Any difference between these lines represents the amount of bond proceeds reported on Schedule K of other unaffiliated healthcare providers.
Schedule K, Part IV, Line 2c Rebate Calculation	Issuer name: MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (2003 HELP Loan) The calculation for computing no rebate due was performed on 12/10/2003
Schedule K, Part IV, Line 2c Rebate Calculation	Issuer name: MICHIGAN STATE HOSPITAL FINANCE AUTHORITY (2006 HELP Loan) The calculation for computing no rebate due was performed on 08/29/2007
Schedule K, Part IV, Line 2c Rebate Calculation	Issuer name: MICHIGAN FINANCE AUTHORITY (2011 HELP Loan) The calculation for computing no rebate due was performed on 06/29/2011
Schedule K, Part IV, Line 2c Rebate Calculation	Issuer name: MICHIGAN FINANCE AUTHORITY (2013 HELP Loan) The calculation for computing no rebate due was performed on 10/10/2013

Schedule K (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) CONNIE S DOWNS	CFO	HIGHER EDUCATION		X	56,500	17,833		No	Yes		Yes





Total ...... $						17,833

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2014

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

Return Reference	Explanation
Form 990, Part IV, Line 12b Consolidated Independent Audited Financial Statements	Pennock Hospital Integrated with Spectrum Health and was included in the Consolidated Independent Audited Financial Statements for the period of May 1, 2015 - June 30, 2015. The activity covering October 1, 2014 - April 30, 2015 is not included in the consolidated audited financial statements.
Form 990, Part VI, Line 4 Significant changes to organizational documents	THE TAXPAYER AFFILIATED WITH SPECTRUM HEALTH SYSTEM DURING THE TAX YEAR AND THE TAXPAYER'S GOVERNING DOCUMENTS WERE SIGNIFICANTLY AMENDED TO SUBSTITUTE SPECTRUM HEALTH SYSTEM AS THE SOLE MEMBER OF THE TAXPAYER. AS A RESULT OF THIS AFFILIATION, THE TAXPAYER'S BOARD WAS EXPANDED TO INCLUDE UP TO SIXTEEN MEMBERS, TWO OF WHICH MUST BE APPOINTED BY SPECTRUM HEALTH SYSTEM. THE TAXPAYER'S BYLAWS WERE AMENDED TO REFLECT THE DELEGATION OF CERTAIN OF THE PARENT CORPORATION'S RESERVED POWERS REGARDING MANAGEMENT AND GOVERNANCE TO SPECTRUM HEALTH HOSPITALS D/B/A SPECTRUM HEALTH HOSPITAL GROUP ("SHHG"), THE BOARD OF WHICH OVERSEES ALL OF THE HOSPITAL OPERATIONS OF SPECTRUM HEALTH. SHHG HAS THE RIGHT TO APPOINT THE PRESIDENT OF THE TAXPAYER. APPROVAL LIMITS FOR THE AMOUNT OF CAPITAL EXPENDITURES OR LOANS TO UNRELATED ENTITIES WERE INCREASED FOR THE TAXPAYER'S PRESIDENT AND BOARD OF DIRECTORS AND AN APPROVAL LIMIT WAS ADDED FOR THE SHHG PRESIDENT, FINANCE COMMITTEE AND BOARD OF DIRECTORS. AMENDMENTS TO THE TAXPAYER'S BYLAWS MUST BE ADOPTED BY SHHG.
Form 990, Part VI, Line 6 Classes of members or stockholders	SPECTRUM HEALTH SYSTEM (EIN 38-3382353), A MICHIGAN NONPROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	THE SOLE MEMBER (SEE FORM 990, PART VI, LINE 6) OF THE ORGANIZATION APPOINTS ALL MEMBERS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	THE SOLE MEMBER OF THE ORGANIZATION (SEE FORM 990, PART VI, LINE 6) HAS RETAINED CERTAIN RESERVED POWERS IN THE ORGANIZATION EXCLUSIVELY, WHICH SHALL NOT BE DEEMED AUTHORIZED UNLESS AND UNTIL APPROVED BY THE SOLE MEMBER OF ORGANIZATION: - ELECTION AND/OR REMOVAL OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND THE ORGANIZATION'S CHAIR OF THE BOARD; - APPROVAL OF ALL ORGANIZATION'S (OR AN ENTITY DIRECTLY OR INDIRECTLY CONTROLLED BY THE ORGANIZATION ("SUBSIDIARY") CAPITAL EXPENDITURES IN EXCESS OF THE AMOUNT SPECIFIED IN THE AUTHORITY MATRIX, ADOPTED BY THE SOLE MEMBER OF ORGANIZATION AND AS AMENDED BY THE SOLE MEMBER OF ORGANIZATION FROM TIME TO TIME ("AUTHORITY MATRIX AMOUNT"); - APPROVAL OF ALL BORROWING BY THE ORGANIZATION OR A SUBSIDIARY FOR CAPITAL OR OPERATING PURPOSES, AND ALL GUARANTEES OF INDEBTEDNESS, INCLUDING ANY OPERATING LEASE IN AN AMOUNT GREATER THAN ONE MILLION DOLLARS ($1,000,000) DURING\ THE INITIAL LEASE TERM, NOT INCLUDING RENEWALS AND/OR EXTENSIONS; - APPROVAL OF ALL LOANS IN EXCESS OF THE AUTHORITY MATRIX AMOUNT BY THE ORGANIZATION OR A SUBSIDIARY TO PERSONS OR ENTITIES OTHER THAN THE SOLE MEMBER OF ORGANIZATION OR AN ENTITY CONTROLLED BY THE SOLE MEMBER OF ORGANIZATION; - THE CREATION OF ANY ENTITY CONTROLLED, DIRECTLY OR INDIRECTLY, BY THE ORGANIZATION; AND - THE ORGANIZATION'S OR ANY SUBSIDIARY'S INVESTMENTS OF CASH AND/OR RESERVES, WHETHER ON AN INDIVIDUAL BASIS OR AS PART OF A POOLED INVESTMENT STRATEGY. IN ADDITION TO THE RESERVED POWERS RETAINED EXCLUSIVELY BY THE SOLE MEMBER OF ORGANIZATION ABOVE, THE SOLE MEMBER OF ORGANIZATION HAS DELEGATED CERTAIN RESERVED POWERS IN ORGANIZATION REGARDING MANAGEMENT AND GOVERNANCE TO SPECTRUM HEALTH HOSPITALS D/B/A SPECTRUM HEALTH HOSPITAL GROUP ("SHHG"), THE BOARD OF WHICH OVERSEES ALL OF THE HOSPITAL OPERATIONS OF THE SOLE MEMBER OF ORGANIZATION. THE SOLE MEMBER OF ORGANIZATION ALSO RETAINS THE UNILATERAL AUTHORITY TO EXERCISE ANY OF THE RESERVED POWERS BELOW. THE ACTIONS LISTED BELOW MAY BE UNILATERALLY CAUSED AND OR TAKEN BY SHHG, WITHIN ITS SOLE AND EXCLUSIVE POWER AND DISCRETION AND SHALL NOT BE DEEMED AUTHORIZED UNLESS AND UNTIL APPROVED BY SHHG: - HIRING, DISCHARGE, AND EVALUATION OF THE ORGANIZATION'S PRESIDENT AND/OR CEO AS DELEGATED BY THE SOLE MEMBER OF ORGANIZATION'S BOARD OF DIRECTORS TO THE SOLE MEMBER OF ORGANIZATION'S CHIEF EXECUTIVE OFFICER (OR DESIGNEE) OR SHHG'S PRESIDENT; - THE ADOPTION OF THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION, AND ANY AMENDMENTS TO SUCH BUDGETS IN EXCESS OF THE AUTHORITY MATRIX AMOUNT; - THE ADOPTION OF THE ORGANIZATION'S STRATEGIC PLANS; - THE ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; - MERGER OR CONSOLIDATION OF THE ORGANIZATION OR A SUBSIDIARY, ANY OTHER CHANGE IN CONTROL, OWNERSHIP PERCENTAGES OR CAPITAL STRUCTURE OF THE ORGANIZATION OR A SUBSIDIARY; - SALE OR TRANSFER OF MORE THAN TEN PERCENT (10%) OF THE ASSETS OF THE ORGANIZATION OR A SUBSIDIARY TO ANY PERSON OR ENTITY NOT CONTROLLED BY THE SOLE MEMBER OF ORGANIZATION; - DISSOLUTION OF THE ORGANIZATION; - THE SELECTION AND RETENTION OF AUDITORS FOR THE ORGANIZATION OR A SUBSIDIARY; AND - ANY OTHER APPROVAL FOR WHICH THE SOLE MEMBER OF ORGANIZATION'S APPROVAL IS REQUIRED BY LAW.
Form 990, Part VI, Line 11b Review of form 990 by governing body	A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE REVIEW PROCESS FOR THIS FORM 990 IS AS FOLLOWS: 1. PREPARATION OF THE RETURN IS SUPERVISED AND REVIEWED BY THE ORGANIZATION'S CORPORATE TAX MANAGER. 2. A SECOND REVIEW IS PERFORMED BY AN EXTERNAL CPA FIRM WITH EXPERTISE IN TAX-EXEMPT RETURN PREPARATION. 3. THE RETURN IS REVIEWED BY THE ORGANIZATION'S FINANCE AND LEGAL DEPARTMENTS AND SHARED WITH THE BOARD OF DIRECTORS. 4. THE ORGANIZATION'S CORPORATE CONTROLLER REVIEWS COMMENTS OR QUESTIONS RECEIVED BY MEMBERS OF THE BOARD OF DIRECTORS, IF ANY, TO ADDRESS OR TO INCORPORATE, AS APPROPRIATE, INTO THE RETURN PRIOR TO FILING.
Form 990, Part VI, Line 12c Conflict of interest policy	ANNUAL CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY BOARD MEMBERS. MEMBERS ARE RESPONSIBLE FOR FULL DISCLOSURE OF POTENTIAL CONFLICTS WHICH ARE DOCUMENTED IN THE MINUTES. ANY INDIVIDUAL WITH A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING ON ANY RELEVANT ITEMS.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	PENNOCK USES SALARY SURVEYS ALONG WITH HIRING A CONSULTING COMPANY IN ASSISTING WITH SETTING WAGES FOR THE OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE IS COMPRISED OF THREE BOARD MEMBERS TO REVIEW COMPENSATION AND ADVISE THE FULL BOARD OF SALARIES, RAISES, AND BENEFITS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2015. ALL DISCUSSIONS FROM THE COMPENSATION COMMITTEE ARE DOCUMENTED IN MINUTES.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	SEE EXPLANATION PROVIDED FOR FORM 990, PART VI, LINE 15A.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S ARTICLES OF INCORPORATION HAVE BEEN PROVIDED TO THE STATE OF MICHIGAN AND ARE AVAILABLE TO THE PUBLIC ON THE STATE'S WEBSITE. THE ORGANIZATION'S BYLAWS AND INTERNAL POLICIES ARE GENERALLY NOT MADE AVAILABLE TO THE PUBLIC. THE OVERALL SYSTEM CONSOLIDATED FINANCIAL STATEMENTS ARE PROVIDED AT WWW.SPECTRUMHEALTH.ORG IN THE SECTION TITLED "ABOUT US".
Form 990, Part IX, Line 11g Other Fees	Contracted Services - Total Expense: 6877548, Program Service Expense: 4116346, Management and General Expenses: 2761202, Fundraising Expenses: ; Medical Services - Total Expense: 65520, Program Service Expense: 55692, Management and General Expenses: 9828, Fundraising Expenses: ; Public Relations - Total Expense: 29700, Program Service Expense: 14850, Management and General Expenses: 14850, Fundraising Expenses: ; Collections - Total Expense: 237820, Program Service Expense: , Management and General Expenses: 237820, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Equity Classification Adjustments - 2381898; Valuation Adjustment - Integration into Spectrum Health - -9452675; Integration Adjustment - -380335;
Form 990, Part XII, Line 2b Audited Financial Statements	Pennock Hospital Integrated with Spectrum Health and was included in the Consolidated Independent Audited Financial Statements for the period of May 1, 2015 - June 30, 2015. The activity covering October 1, 2014 - April 30, 2015 is not included in the consolidated audited financial statements.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Pennock Hospital

Employer identification number

38-1360562

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) PENNOCK FOUNDATION 1009 WEST GREEN STREET HASTINGS,MI49058 38-2713275	FOUNDATION	MI	501(c)(3	Type III-FI	Spectrum Health System		No
(2) PENNOCK HEALTHCARE SYSTEM 1009 WEST GREEN STREET HASTINGS,MI49058 38-2713276	PARENT ORGANIZATION	MI	501(c)(3	Type II	Spectrum Health System		No
(3) Priority Health 1231 East Beltline NE Grand Rapids,MI49525 38-2715520	HMO	MI	501(c)(4		Spectrum Health System		No
(4) Spectrum Health Hospitals 100 Michigan St NE Grand Rapids,MI49503 38-1360529	Health Care	MI	501(c)(3	3	Spectrum Health System		No
(5) Spectrum Health Primary Care Partners 1840 Wealthy St SE Grand Rapids,MI49506 38-1358164	Healthcare	MI	501(c)(3	3	Spectrum Health System		No
(6) Spectrum Health Foundation 100 Michigan St NE Grand Rapids,MI49503 38-2752328	Philanthropy	MI	501(c)(3	7	Spectrum Health System		No
(7) Spectrum Health Continuing Care 750 Fuller Ave NE Grand Rapids,MI49503 38-3242232	Rehab/Care	MI	501(c)(3	9	Spectrum Health System		No
(8) Newaygo County General Hospital Association 212 S Sullivan Avenue Fremont,MI49412 38-1359517	Healthcare	MI	501(c)(3	3	Spectrum Health System		No
(9) Zeeland Community Hospital 8333 Felch Street Zeeland,MI49464 38-1411184	Healthcare	MI	501(c)(3	3	Spectrum Health System		No
(10) Spectrum Health United 615 S Bower Greenville,MI48838 38-1358412	Healthcare	MI	501(c)(3	3	Spectrum Health System		No
(11) Mecosta County Medical Center 605 Oak Street Big Rapids,MI49307 38-1368744	Healthcare	MI	501(c)(3	3	Spectrum Health System		No
(12) Memorial Medical Center of West Michigan One Atkinson Drive Ludington,MI49431 38-1359266	Healthcare	MI	501(c)(3	3	Spectrum Health System		No
(13) REED CITY HOSPITAL CORPORATION 300 N PATTERSON RD REED CITY,MI49677 38-2770076	Healthcare	MI	501(c)(3	3	Spectrum Health System		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2014

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) Pennock Ventures Inc 1009 West Green Street Hastings,MI49058 38-2712819	Real Estate	MI	NA	C Corporation				No
(2) Priority Health Insurance Company 1231 East Beltline NE Grand Rapids,MI49525 20-1529553	Insurance	MI	NA	C Corporation				No
(3) Priority Health Managed Benefits 1231 East Beltline NE Grand Rapids,MI49525 38-3085182	Third Party Administrator	MI	NA	C Corporation				No
(4) Ideomed Inc 100 Michigan St NE Grand Rapids,MI49503 61-1613614	Information Technology	MI	NA	C Corporation				No
(5) Michigan Medical Patient Care 1840 Wealthy St SE Grand Rapids,MI49506 38-2851295	Medical	MI	NA	C Corporation				No
(6) West Michigan Heart 2900 Bradford Street NE Grand Rapids,MI49525 38-2125186	Physicians	MI	NA	C Corporation				No
(7) Spectrum Health Physician Alliance 100 Michigan St NE Grand Rapids,MI49503 37-1655728	Physicians	MI	NA	C Corporation				No
(8) Pennock Pharmacy Inc 1009 West Green Street Hastings,MI49058 38-2750680	Health Care	MI	NA	C Corporation				No

Schedule R (Form 990) 2014

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Pennock Foundation	M	3,924	Cash, GAAP, or FMV
(2) Pennock Foundation	P	97,947	Cash, GAAP, or FMV
(3) Pennock Foundation	N	44,332	Cash, GAAP, or FMV

Schedule R (Form 990) 2014

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2014

Additional Data

Software ID:	14000329
Software Version:	2014v1.0

1	Briefly describe the organization’s mission or most significant activities: The Hospital's primary mission is to provide healthcare services to the citizens of Barry County. All activities associated with this purpose are included in determination of the operating income. Net assets of the hospital are generally unrestricted and are available for the delivery of healthcare services, with the exception of contributions from individual donors, which are temporarily restricted for the purpose intended by the donor. The hospital provides care to all patients regardless of their ability to pay. Patients who meet certain criteria under its charity care policy receive care without charge or at amounts less than established rates. Because the hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	740
6	Total number of volunteers (estimate if necessary) .............	6	114
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	160,324
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	7,100

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	20,579	4,551
9	Program service revenue (Part VIII, line 2g) .........	62,439,958	49,640,649
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,368,548	5,133,623
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	568,066	596,991
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	71,397,151	55,375,814
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	34,926,021	29,880,875
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	33,961,000	27,224,579
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	68,887,021	57,105,454
19	Revenue less expenses. Subtract line 18 from line 12.......	2,510,130	-1,729,640
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	108,322,226	99,664,710
21	Total liabilities (Part X, line 26).............	19,295,604	19,810,085
22	Net assets or fund balances. Subtract line 21 from line 20.....	89,026,622	79,854,625

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 41,172,110 including grants of $ 0 ) (Revenue $ 49,640,649 )
	PENNOCK CONTINUES TO INVEST IN PHYSICIAN INTEGRATION IN ORDER TO BETTER SERVE THE RURAL SECTIONS OF THE MARKET. PRIMARY CARE PHYSICIAN ADJUSTMENTS AND GROWTH OCCURRED IN BARRY COUNTY. OUR CONTINUOUS INVESTMENTS IN ELECTRONIC MEDICAL RECORDS, THE IMPROVEMENTS IN OUR CURRENT FACILITY, AND THE DEVELOPMENT OF A SEAMLESS CIRCLE OF CARE HELP TO ENHANCE PENNOCK'S SERVICE TO THE COMMUNITY.

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 expenses41,172,110

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(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
(A) Name and Title
(18) Jim Wincek VP Support Services	40.00 .......................0	X		131,817	0	8,791
(19) Bob Davis Exec. Dir. Physican Network	40.00 .......................0	X		144,736	0	27,497
(20) James Horton MD Physician	40.00 .......................0		X	505,590	0	16,403
(21) Eric Leep MD Physician	40.00 .......................0		X	468,024	0	31,788
(22) David Heeringa MD Physician	40.00 .......................0		X	366,355	0	21,071
(23) Laura Doherty MD Physician	40.00 .......................0		X	362,046	0	7,384
(24) Max Rappaport MD Physician	40.00 .......................0		X	337,641	0	42,943

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,221,424	1,064,458	552,236

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		4,551

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			4,551
			Business Code
2a	Patient Service Revenue		621110	49,627,796	49,627,796
b	Meaningful Use Projects		621110	12,853	12,853
c
d
e
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			49,640,649
3	Investment income (including dividends, interest, and other similar amounts).......			495,959			495,959
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	593,747
b	Less: rental expenses	485,444
c	Rental income or (loss)	108,303	0
d	Net rental income or (loss).......			108,303			108,303
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	57,848,917	0
b	Less: cost or other basis and sales expenses	53,194,614	16,639
c	Gain or (loss)	4,654,303	-16,639
d	Net gain or (loss)..........			4,637,664			4,637,664
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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...
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..
Miscellaneous Revenue			Business Code
11a	Cafeteria Revenue		722100	254,605			254,605
b	Miscellaneous		900099	73,759			73,759
c	Lab Courier Service		621500	160,324		160,324
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			488,688
12	Total revenue. See Instructions......			55,375,814	49,640,649	160,324	5,570,290


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			130,511	1	72,861
2	Savings and temporary cash investments .........			6,293,541	2	3,475,833
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			8,453,773	4	8,255,966
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				56,500	5	17,833
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net .............			6,092,948	7	5,029,388
8	Inventories for sale or use ..............			998,923	8	1,014,463
9	Prepaid expenses and deferred charges ..........			559,292	9	598,407
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	47,143,077
b	Less: accumulated depreciation .....	10b	31,634,700	24,736,525	10c	15,508,377
11	Investments—publicly traded securities ..........			59,400,385	11	64,130,064
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 .....			0	13
14	Intangible assets ...............			630,000	14	0
15	Other assets. See Part IV, line 11 ...........			969,828	15	1,561,518
16	Total assets. Add lines 1 through 15 (must equal line 34)......			108,322,226	16	99,664,710
17	Accounts payable and accrued expenses .........			5,850,607	17	7,193,195
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			11,930,362	20	10,743,760
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other 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 ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			1,514,635	25	1,873,130
26	Total liabilities. Add lines 17 through 25.........			19,295,604	26	19,810,085
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			88,207,439	27	78,378,249
28	Temporarily restricted net assets ...........			819,183	28	1,022,060
29	Permanently restricted net assets ...........				29	454,316
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			89,026,622	33	79,854,625
34	Total liabilities and net assets/fund balances ........			108,322,226	34	99,664,710