Civic Intelligence

Herrick Memorial Hospital Inc

EIN 38-3049015 • 501(c)3 • Toledo, OH

Profile

Herrick memorial hospital, inc. Is an acute care critical access hospital that provides health care dedicated to improving human life, and is devoted to the patients and families we serve through innovative care, superior quality and premier customer service.

100 Madison Ave Attn Tax DepartmToledo, OH 43604

www.promedica.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

99th percentile

2.91x

Higher debt load relative to assets than 99% of similar nonprofits.

501(c)3 • $5M-$10M nonprofits • Source year 2021

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on the latest valid filing.

Source year 2021

Net Margin

Score unavailable

No value available

Net margin requires both revenue and expenses on the latest valid filing.

Source year 2021

Top Officer Pay

100th percentile

$7,456,116

Higher top officer pay than 100% of similar nonprofits.

501(c)3 • $5M-$10M nonprofits • Source year 2021

Asset Growth

28th percentile

-2.1%

Faster asset growth than 28% of similar nonprofits.

501(c)3 • $5M-$10M nonprofits • Annualized from 2020 to 2021

Revenue Growth

1st percentile

-100%

Faster revenue growth than 1% of similar nonprofits.

501(c)3 • $5M-$10M nonprofits • Annualized from 2020 to 2021

Assets

Down

$5,820,562

Down $126,039 (-2.1%) from 2020

Liabilities

Down

$16,966,154

Down $114,553 (-0.7%) from 2020

Net Assets

Down

-$11,145,592

Down $11,486 (-0.1%) from 2020

Revenue

Down

$0

Down $19,226,299 (-100%) from 2020

Expenses

Down

$0

Down $21,194,724 (-100%) from 2020

Net Income

Up

$0

Up $1,968,425 (+100%) from 2020

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$150M$100M$50M$0-$50MAssets 2010: $85,126,338Liabilities 2010: $23,061,170Net Assets 2010: $62,065,1682010Assets 2011: $91,209,574Liabilities 2011: $22,997,365Net Assets 2011: $68,212,2092011Assets 2012: $96,372,562Liabilities 2012: $21,733,967Net Assets 2012: $74,638,5952012Assets 2013: $101,073,805Liabilities 2013: $21,495,990Net Assets 2013: $79,577,8152013Assets 2014: $100,915,434Liabilities 2014: $20,627,857Net Assets 2014: $80,287,5772014Assets 2015: $105,140,260Liabilities 2015: $21,920,375Net Assets 2015: $83,219,8852015Assets 2016: $94,569,296Liabilities 2016: $19,281,731Net Assets 2016: $75,287,5652016Assets 2017: $95,104,547Liabilities 2017: $19,690,675Net Assets 2017: $75,413,8722017Assets 2018: $82,318,502Liabilities 2018: $20,022,619Net Assets 2018: $62,295,8832018Assets 2019: $79,610,197Liabilities 2019: $20,334,173Net Assets 2019: $59,276,0242019Assets 2020: $5,946,601Liabilities 2020: $17,080,707Net Assets 2020: -$11,134,1062020Assets 2021: $5,820,562Liabilities 2021: $16,966,154Net Assets 2021: -$11,145,5922021

Highlighted filing

2021

Assets$5,820,562
Liabilities$16,966,154
Net Assets-$11,145,592

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$60M$40M$20M$0-$20MExpenses 2010: $39,003,0372010Expenses 2011: $41,900,2632011Expenses 2012: $37,000,8262012Revenue 2013: $38,686,381Expenses 2013: $38,789,027Net Income 2013: -$102,6462013Revenue 2014: $38,518,219Expenses 2014: $37,830,905Net Income 2014: $687,3142014Revenue 2015: $36,314,929Expenses 2015: $34,308,426Net Income 2015: $2,006,5032015Revenue 2016: $28,873,551Expenses 2016: $34,203,251Net Income 2016: -$5,329,7002016Revenue 2017: $30,938,878Expenses 2017: $34,321,817Net Income 2017: -$3,382,9392017Revenue 2018: $30,125,530Expenses 2018: $31,049,065Net Income 2018: -$923,5352018Revenue 2019: $26,626,752Expenses 2019: $28,760,250Net Income 2019: -$2,133,4982019Revenue 2020: $19,226,299Expenses 2020: $21,194,724Net Income 2020: -$1,968,4252020Revenue 2021: $0Expenses 2021: $0Net Income 2021: $02021

Highlighted filing

2021

Revenue$0
Expenses$0
Net Income$0

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2021 to Dec 31, 2021
Signed
Nov 7, 2022
Return Version
2021v4.2
Gross Receipts
$0
Mission and Program Overview

Mission

Herrick memorial hospital, inc. Is an acute care critical access hospital that provides health care dedicated to improving human life, and is devoted to the patients and families we serve through innovative care, superior quality and premier customer service.

Herrick memorial hospital, inc. Is an acute care critical access hospital that provides healthcare services to all indivduals in lenawee county.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$4,209,155$4,701,071▲ $491,916
Accounts Receivable$1,395,485$1,119,491▼ $275,994
Total Assets$5,946,601$5,820,562▼ $126,039
Other Assets Total$341,961$0▼ $341,961
Liabilities
Other Liabilities$17,044,406$16,894,427▼ $149,979
Accounts Payable and Accrued Expenses$36,301$71,727▲ $35,426
Total Liabilities$17,080,707$16,966,154▼ $114,553
Net Assets / Fund Balance
Net Assets With Donor Restrictions$10,400$10,400→ $0
Net Assets Without Donor Restrictions$-11,144,506$-11,155,992▼ $11,486
Total Net Assets Fund Balance$-11,134,106$-11,145,592▼ $11,486
Total Liabilities and Net Assets / Fund Balance$5,946,601$5,820,562▼ $126,039
Compensation and Service Providers

Board Members and Trustees

NameTitle
Marcy L BrownChairman
Paula K HoltzVice Chairman
Aaron D SwiggumTrustee
Dennis M SmokeTrustee
Elizabeth a KennedyTrustee
Frank DickTrustee
Gary E McdowellTrustee
Grace M GarnoTrustee
John C AkensTrustee
Marcia J Boynton JdTrustee
Marsha L DavisTrustee
Michael B AdamsTrustee
Michael J UckeleTrustee
Rick K KnierimTrustee
Russell L DempseyTrustee
Edward J EngleTrustee (partial Year)
Victor J Cherfan DoTrustee (partial Year), Physician
Paul E Gietzen MdTrustee, Physician
Darrin ArquetteTrustee, Pres. Regional Acute Care
Christi L AnsbergTrustee,VP, Philanthropy
Gary W AkenbergerCOO, Acute Care & SVP, Diag
Dawn M BuskeyEx Officio, Pres. Acute Care
Alan M SattlerFormer Treasurer, VP Business Dev.
Randall OostraPhs Pres. & CEO
Julie K Yaroch DoPres., Ex Officio
Jeffrey C KuhnSecretary, Chief Legal Officer
Deana SievertSr VP, Pat Care/CNO, System
Steven M CavanaughTreasurer, CFO
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$0
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$0
Other Expenses$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Affiliates$16,894,427
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

As a michigan non-profit organization, this corporation has a corporate member.

Form 990, Part VI, Section A, Line 7A

Promedica health system, inc. (phs) is the parent corporation and sole member of herrick memorial hospital, inc. As the member, phs has the right to (a) elect and remove the members of the board of trustees of herrick memorial hospital, inc. And (b) fill any vacancy on the board of trustees.

Form 990, Part VI, Section A, Line 7B

While the board of trustees of each business unit is granted certain powers with respect to such business unit's operations, as the member, promedica health system, inc. Retains approval rights with respect to certain corporate actions such as (i) adoption of the business unit's strategic plans and financial plans, (ii) expenditures for non-budgeted items in excess of certain dollar limits set from time to time by the member, (iii) expenditures for items which are included in the business unit's annual budgets but which exceed the budgeted amount by an amount in excess of certain dollar limits set from time to time by the member, (iv) incurrence, assumption or guarantee of any indebtedness, (v) sale, lease or other disposition of real property or assets with a value in excess of certain dollar limits set from time to time by the member and (vi) any merger, consolidation, reorganization, dissolution or liquidation.

Form 990, Part VI, Section B, Line 11B

The 990 returns of promedica health system, inc. (phs) and its subsidiaries are prepared by the phs tax department with the assistance of finance. The returns are reviewed by the avp of tax before being provided to the respective company's board of trustees prior to filing. Any comments or questions from the board are reviewed and incorporated into the return if appropriate. Final returns are provided to a principal officer for signature prior to filing with the internal revenue service.

Form 990, Part VI, Section B, Line 12C

Promedica health system, inc. And affiliates (phs) have standards of conduct that apply to all phs board members and employees. Board members and employees are expected to certify their compliance with the applicable standards prior to election/appointment or prior to beginning employment. Board members annually (or immediately if new potential conflicts of interest arise), all board members are required to complete and return the board member soc survey within 30 days of dissemination. Board member soc surveys are reviewed by the v.p., audit & compliance/chief compliance officer (cco). Summarized information is forwarded for review to the chief financial officer, general counsel, business unit presidents and the president and chief executive officer (president/ceo), based upon their respective knowledge of the board members. The purpose of this review is to both inform management of the disclosed conflicts and to allow them to identify to the v.p., audit & compliance, any potential undisclosed conflicts. The audit & compliance department then conducts an audit of all board member soc surveys (along with any relationships noted through the above review) to identify any positional conflicts of interest and to test material transactions with board members/their affiliates for fair market value. The results of the audit are reported directly to the chair of the audit & compliance committee with a copy to the president/ceo. The report includes a summary of the audit procedures performed, any significant concerns identified, and their resolution. Any unresolved conflicts are addressed by the audit committee with recommendations to the full board as needed. Failure to complete the survey or the submission of a false or incomplete survey, or failure to disclose immediately any new conflicts of interest that may arise, or failure to cooperate without condition, honestly and completely with any investigation or review of the board member's survey results or his/her actions or circumstances shall be grounds for sanction by the board of trustees up to and including removal from the board/committee/council. Employees, excluding employed providers annually (or immediately if new conflicts of interest arise), all bonus-eligible senior leadership and specifically identified additional employees, are required to complete and submit an electronic employee certification questionnaire by an established deadline that is communicated to the employee. The human resources department ensures that all questionnaires, which are stored electronically, are completed and provides notification to the v.p., audit & compliance of the number of annual employee certification questionnaires sent and received and copies of any questionnaires containing disclosures that warrant further review by the audit & compliance department. All new employees, excluding employed providers, are provided either an electronic or paper copy of the employee standard of conduct and the employee certification statement which the new employee is required to complete prior to beginning employment. The audit & compliance department has access to a report that identifies all new hires. A sample of employees is identified and an audit is conducted to ensure that required documentation is on file. Identified conflicts are initially reviewed by the v.p., audit & compliance and if necessary discussed with the business unit president in which the employee works, the chief human resource officer, and general counsel. If the conflict is considered a significant exposure risk for phs, a recommendation will be prepared for final approval of the phs president/ceo. Results of the employee process audit are included in the above report to the chair of the audit & compliance committee. Failure to complete the certification questionnaire, or the completion of a false or incomplete certification questionnaire, or failure to disclose immediately any new conflicts of interest that may arise, or failure

Form 990, Part VI, Section B, Line 15

Herrick memorial hospital, inc.'s top management official and other officers are compensated by promedica health system, inc. (phs), a related tax-exempt organization. Compensation determinations of promedica foundation's top management official and other officers are made by a compensation committee of phs. Each year independent consultants conduct an annual survey and recommend executive payroll base salary ranges based upon the market. The data is reviewed and approved by the promedica health system compensation committee every october. Salary adjustments are determined at the december meeting of the compensation committee. The compensation committee approves other forms of compensation based upon the prior year performance at the january meeting each year.

Form 990, Part VI, Section C, Line 19

Promedica health system, inc. And subsidiaries provide any document open to public inspection upon request.

Filing and Contact Details

Filer

Filer Name
Herrick Memorial Hospital Inc
EIN
38-3049015
Phone
4192525772
Address
100 MADISON AVE ATTN TAX DEPARTM, TOLEDO, OH 43604
Doing Business As
Promedica Herrick Hospital

Signing Officer

Name
Steven M Cavanaugh
Title
Treasurer
Phone
4192525772
Signed
2022-11-07
Discuss with paid preparer
No

Organization Details

Principal Officer
Louis Robichaux
Formed
1989
Legal Domicile
Mi
Voting Board Members
20
Independent Board Members
15
Employees
0
Volunteers
15
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 3

The herrick memorial hospital ceased operations in 2020. At that time all program services transferred to promedica charles and virginia hickman hopsital that continues to serve adrian michigan and surrounding communities as an acute care facility providing inpatient and outpatien and health care services to the general public. Herrick memorial hospital, inc. Is an inactive entity that is in the process of winding down towards legal dissolution.

FORM 990, PART IV, LINE 24A:

Herrick memorial hospital, inc. Is a health facility that is a subsidiary of promedica health system, inc. (phs). Herrick memorial hospital, inc. Holds an intercompany note payable to the toledo hospital, which is also a subsidiary of phs. The note payable represents herrick memorial hospital, inc.'s portion of taxable and tax-exempt bonds issued by promedica healthcare obligated group.

FORM 990, PART XI, LINE 9:

Beneficial interest in foundation transfers between related entities -11,486. Transfer equipment to related entities transfer of securities to toledo hospital transfer assets to emma l bixby hospital

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IRS990/Form990PartVIISectionAGrp/TitleTxt20TRUSTEE
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IRS990/Form990PartVIISectionAGrp/TitleTxt23SECRETARY, CHIEF LEGAL OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt24TREASURER, CFO
IRS990/Form990PartVIISectionAGrp/TitleTxt25SR VP, PAT CARE/CNO, SYSTEM
IRS990/Form990PartVIISectionAGrp/TitleTxt26COO, ACUTE CARE & SVP, DIAG
IRS990/Form990PartVIISectionAGrp/TitleTxt27FORMER TREASURER, VP BUSINESS DEV.
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IRS990/MissionDesc0THE HERRICK MEMORIAL HOSPITAL, INC. IS AN ACUTE CARE CRITICAL ACCESS HOSPITAL THAT PROVIDES HEALTH CARE DEDICATED TO IMPROVING HUMAN LIFE, AND IS DEVOTED TO THE PATIENTS AND FAMILIES WE SERVE THROUGH INNOVATIVE CARE, SUPERIOR QUALITY, AND PREMIER CUSTOMER SERVICE.
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