2025-02-09T13:24:22-07:00 2024-03-31 990 2023-04-01 381369796 SHERIDAN COMMUNITY HOSPITAL SHER 9892916235 301 N Main Sheridan MI 48884 Newton Mulama Controller 9892916235 2025-02-10 1 2023 2025-03-06 01:10:19Z X Ljiljana Petricevic 301 N Main Street Sheridan MI 48884 13830607 0 X sheridanhospital.com X 1950 MI Dedicated to provide individual based quality healthcare to the families in our rural community 5 0 132 6 0 0 7725643 1140152 9630294 12683240 0 0 114981 7215 17470918 13830607 0 0 0 235049 11307520 9689150 0 0 0 4092095 7356416 15399615 17280615 2071303 -3450008 9837304 9440970 6199741 8391530 3637563 1049440 Dedicated to provide individual based Quality healthcare to the families in our rural community 0 0 17280615 1126570 12186827 Sheridan Community Hospital provided care to 54 inpatients and 65 swing bed patients with a total of 743 patient days of care. It also provided outpatient care to 18,608 patients while its Hospital's Rural Health Clinic provided 7,749 primary care physician encounters. The hospital provided a total of $42,557 for charity care to local patients from the community. 0 0 0 17280615 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 132 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Sheridan Community Hospital 9892913261 301 N Main Sheridan MI 48884 Doctor Eva Bartlett Chief Medical Officer 40 0.00 X X 547941 0 16772 Lilijana Petricevic Chief Executive Officer/Chief Operating Officer 40.0 0.00 X X 261979 0 26061 Doctor Stephen Frey Emergency Room physician 36.00 0.0 X 231955 0 13736 Doctor Michael Cearlock Emergency Room Physician 36 0.0 X 193545 0 6402 Julie Calderone Vice President operations and clinical services 40.00 0 X X 178494 0 13693 Ryan Holley-Mallo Emergency Room Physician 36.00 X 162198 0 13825 Newton Mulama Controller 40 0.00 X 145763 0 11479 Einer Thorlund Emergency Room Physician 32 0 X 138435 0 0 Mary Thomas Pharmacy Manager 32 0 X X 124455 0 10267 Gina Bennett NP Hospitalist 40 0 X 106263 0 16772 Brian Thwaites Physician Assistant- Rural Health Clinic 40 0 X 121434 0 614 Kim Christensen Risk Manager 40 0 X X 90256 0 9366 Cindy Pena Human Resources Manager 40 0 X 78310 0 13736 James Dimitriou Compliance Officer 40 0 X X X 70077 0 17328 Jalil Rizqallah President of the Hospital 2 X 18368 0 0 Mary Soper RHC Practice Manager 40 0 X 14377 0 1402 Bobbi McColley Chief Compliance Officer 2 X 15227 0 235 Doctor Mark Clark Vice President - Hospital 2 0 X 12346 0 0 Sarah Mitchell Executive Assistant 40 0 X 9103 0 482 Sarah Fryover Director - Human Resources 40.00 0 X 6151 0 0 2526677 0 172170 11 0 1 0 Rural Health Management 13634 23 Mile Rd Hersey MI 49639 Consultant- Hospital Business operations 388061 Medical Solutions Post office Box 850737 Meniappolis MN 55485 Nurse Staffing Agency 225025 Celebrity Anesthesia Staffing 3809 VALLEY VIEW RD Austin TX 78704 Anesthisiology Staffing 222266 Samaritan Health Care PC 811 E Kent Rd Greenville MI 48838 Pain Management 168364 Phillips North America LLC POST OFFICE BOX 100355 ATLANTA GA 30384 MEDICAL EQUIPMENT 148516 5 0 12017 1564 0 1024540 102031 0 1140152 Patient Services Net Revenue 622110 10746434 10746434 0 0 QAAP Medicaid Payments 900099 1118393 1118393 0 0 340B pharmacy Program 621999 102288 102288 0 0 Program Incentive Payments 900099 716125 716125 0 0 0 0 0 0 12683240 7215 0 0 0 7215 0 7215 7215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13830607 12690455 0 0 235049 235049 136561 136561 1119658 1119658 5243042 5243042 136561 136561 1119658 1119658 1933670 1933670 704221 704221 250455 250455 83268 83268 1526233 1526233 42848 42848 21177 21177 433261 433261 1007119 1007119 3513 3513 11509 11509 8568 8568 821136 821136 213573 213573 Provision For Bad Debt 1563194 1563194 0 0 Medicaid Provider Tax 442879 442879 0 0 340B Program Expense 132710 132710 0 0 90752 90752 17280615 17280615 0 0 1219772 143882 302500 302500 0 2353687 3066882 0 0 0 659733 383361 84000 109733 5434612 0 5217612 5434612 9837304 9440970 2960304 3831322 3239437 4560208 6199741 8391530 X 3637563 1049440 0 0 3637563 1049440 9837304 9440970 -3450008 0 0 0 861885 0 X 0 0 0 X 0 1 0 0 0 1 7400 1 62001 0 0 69401 0 Schedule C, Part II-B, Line 1 Sheridan Community Hospital engaged the services of an attorney as the government relations officer at the state capital to interact with the legislative governing body in the state of Michigan. The hospital is also a member of MHA and pays annual dues. MHA engaged an attorney to lobby for healthcare/Hospitals policies at federal and state levels of government. 633238 0 633238 1315503 0 0 1315503 0 0 0 0 3485871 0 0 3485871 0 0 0 0 5434612 Capital Leases 1110200 Net Income Loss- Currnt Year 3450008 4560208 1 1 1 X 250 1 X 1 1 0 0 42557 0 0 42557 0 0 0 0 0 0 0 0 0 0 0 42557 0 0 0 4310 10000 0 0 0 0 14310 0 1 1563194 42557 0 0 0 X 1 1 1 1 Sheridan Community Hospital 301 N Main Street Sheridan MI 48884 www.sheridanhospital.com 1060000119 X X X X Sheridan Community Hospital 1 0 0 0 0 1 X 250 400 X X X X 1 1 1 X HTTPS//WWW.SHERIDANHOSITAL.COM/PAYMENTS X HTTPS//WWW.SHERIDANHOSITAL.COM/PAYMENTS X HTTPS//WWW.SHERIDANHOSITAL.COM/PAYMENTS X X X X 1 0 X X X X 1 0 0 Schedule H, Part I, Line 7 Bad Debt Expenses of $1,563,194.00 was excluded from the denominator per instructions when calculating total expenses Schedule H, Part II Sheridan Community Hospital Offers a variety of Health and Wellness Programs including Education workshops, health screening, Community Fairs. Blood Pressure clinics, diabetes education free of charge. Schedule H, Part III, Section A, Line 4 To evaluate collectability of the patient account receivable, hospital uses historical data to pick up trends for its main payors to estimate an appropriate allowance for bad debt. Schedule H, Part III, Section B, Line 8 Costing Methodology - a cost to charge ratio Schedule H, Part III, Section C, Line 9b Patients Fill out a Financial Assistance Program Application after eligibility verification for Medicaid has been attempted and a Medicaid application placed if they qualify. Schedule H, Part VI, Line 2 Participating in Community Initiatives Every 3 years Schedule H, Part VI, Line 3 Information is posted by our patient access windows and we also have a dedicated financial assistance program employee who reaches out to patients and meets with them regularly to assist in completing application paperwork. Schedule H, Part VI, Line 4 Sheridan Community Hospital and its Rural Health Clinic serve a population of all Ages but continue to see Aging Patients and Have seen an increase in patients who suffer from opioid Abuse. Montcalm County has a large population of Diabetes patients and we often see patients with co-morbidities. X X 0 0 0 0 0 0 0 0 0 Doctor Eva Bartlett Chief Medical Officer 392941 0 155000 0 0 0 0 0 16772 0 564713 0 0 0 Lilijana Petricevic Chief Executive Officer/Chief Operating Officer 261979 0 0 0 0 0 0 0 26061 0 288040 0 0 0 Doctor Stephen Frey Emergency Room physician 231955 0 0 0 0 0 0 0 13736 0 245691 0 0 0 Doctor Michael Cearlock Emergency Room Physician 193545 0 0 0 0 0 0 0 6402 0 199947 0 0 Julie Calderone Vice President operations and clinical services 178494 0 0 0 0 0 0 0 13693 0 192187 0 0 0 Ryan Holley-Mallo Emergency Room Physician 162198 0 0 0 0 0 0 0 13825 0 176023 0 0 0 Newton Mulama Controller 145763 0 0 0 0 0 0 0 11479 0 157242 0 0 0 Schedule J, Part I, Line 3 The Hospital Conducts Market survey for compensation based on similar job group and presents a proposal before the board for a vote. Form 990, Part VI, Section A, Line 3 The Hospital has engaged services of Rural Health Management to serve as the Board Chair Form 990, Part VI, Section B, Line 11b Form Is Presented before The Board Form 990, Part VI, Section B, Line 12c A conflict of Interest questionnaire is completed annually by Board members, reviewed by the Board Secretary and Compliance Officer to ensure that no conflict exists. If a conflict arises the board secretary would bring up the issue for discussion before the board following by-laws governing the board and a decision is made to remedy. Form 990, Part VI, Section B, Line 15 We engage a consultant to review compensation for all positions within the organization at the prevailing competitive market rate. We also use MGMA rates for physician contracts Form 990, Part VI, Section C, Line 19 ANY GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND/ OR FINANCIAL STATEMENTS REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE AVAILABLE UPON REQUEST. We sort the permission to extend filing and it was granted.