2025-04-16T10:23:59-07:00 2024-06-30 990 2023-07-01 381368360 PINE REST CHRISTIAN MENTAL HEALTH SERVICES PINE 6164555000 300 68th Street SE PO Box 165 Grand Rapids MI 495010165 Paul Karsten Vice President & CFO 6164555000 2025-04-16 1 2023 2025-03-06 01:10:19Z Mark Eastburg 300 68th Street SE Grand Rapids MI 49548 250182226 0 X pinerest.org X 1908 MI Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity, and compassion. 20 17 2716 5 0 0 10996200 17723388 188008877 207997471 6208829 4404162 598125 698766 205812031 230823787 0 0 0 0 150638408 161117873 0 0 705090 49159213 56259769 199797621 217377642 6014410 13446145 127654106 145169225 53988080 55585432 73666026 89583793 Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity, and compassion. 0 0 80510767 0 106141798 The organization's largest service program, measured by net revenue, is Hospital & Residential Services (HRS). HRS cares for individuals in both inpatient and partial hospitalization settings as well as a variety of longer-term residential facilities at the organization's Cutlerville, Michigan 280-acre campus. Our services include dedicated psychiatric care for children, adolescents, adults and older adults. Clinical teams address the full array of psychiatric diagnoses. Specialty services are available for treating persons with co-occurring substance abuse diagnoses and psychiatric disorders when treatment is complicated by co-occurring medical conditions. We provide professional assessment and individualized treatment including diagnosis, medication management and education, individual and group therapies, individual and family consultations and therapy, case management, discharge planning and aftercare. The inpatient and partial hospitalization programs are licensed and accredited by the Joint Commission. 69331860 0 72669678 The organization's second largest service program is its Clinic Network. The Clinic Network offers ambulatory outpatient care at nineteen locations throughout Western and Northern Michigan. For people who do not require the structured environment of the inpatient or residential care settings, outpatient services are at the center of the behavioral health continuum. Nearly 75% of all persons who come to Pine Rest are served through outpatient services. Our clinicians provide a broad spectrum of intervention across the age continuum in convenient, non-restrictive environments. In addition to traditional outpatient care, Pine Rest provides a variety of specialty services including telemedicine, assessment through the Psychological Consultation Center, intensive outpatient and residential substance abuse/addictions services, and court-related services and assessments. 9952179 0 13983905 The Pine Rest Residential Division offers longer term psychiatric services to clients with mental health needs in a residential setting. These programs include both locked and unlocked settings. These services and facilities are licensed and accredited by the State of Michigan as well as the Commission on Accreditation of Rehabilitation Facilities (CARF). Adult Residential services had 18,804 patient days of care in fiscal year 2024. 9059125 0 10206235 The organization's third largest program is its psychiatric residency program, conducted in partnership with Michigan State University College of Human Medicine. Pine Rest is devoted to training the psychiatrists of tomorrow by fostering an environment of excellence through our dedication to clinical best practices, patient safety and quality of care, scholarly activities, research, physician wellness as well as diversity and inclusion. Pine Rest instituted its general psychiatry residency program in July 2014. Since that time, we have inaugurated specialty fellowships in Child & Adolescent, Geriatric, Forensic and Addiction. We now train over fifty residents and fellows through five ACGME-accredited programs. Our residents complete rotations under the supervision of attending physicians in a broad array of hospital, residential, and outpatient settings including emergency psychiatry, substance abuse, community mental health, child and adolescent inpatient, adult inpatient, older adult inpatient, primary care, neurology, and outpatient clinic services. Our residents engage in rigorous post-graduate education and research. The Residency Outpatient Clinic conducts 12,000 visits annually, expanding access to quality psychiatry. The goal of this training program is to assure that the State of Michigan has the benefit of highly trained psychiatrists now and in the future. 3276507 0 3635353 Homes for the Developmentally Disabled serves adults with developmental disabilities in exceptional residential settings with multiple opportunities for engaging in on-site and community activities that match abilities. Homes for the Developmentally Disabled services program had 19,076 patient days of care in fiscal year 2024. 1315226 0 1698996 Pine Rest has a Grants Management Program designed to introduce new research and programs to the organization and provide better services to our patients and community. Our Grants Management service line administers several grant programs to further our mission in compliance with the requirements of each grant award. 812195 0 351884 Education and Prevention offers a range of education and prevention activities that help promote community wellness. Pine Rest is the recipient of several grants that promote education and prevention activities around mental health as well as perform research to further determine best practice models of care. An internship program for graduate students studying psychology is offered. 14463053 0 15892468 174257859 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 176 0 1 2716 1 0 0 0 0 0 0 0 0 X 20 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Paul H Karsten 6162816363 300 68th St SE Grand Rapids MI 495010165 Mark C Eastburg PhD President & CEO 58 2 X 613562 0 57510 Marwan Tabbara Medical Staff 55 0 X 588016 0 50019 William Sanders Chief Medical Officer 60 0 X 555851 0 49010 Lindsey Bailey Medical Staff 55 0 X 520083 0 32949 Bibhas Singla Medical Staff 55 0 X 474686 0 49010 James Eicher Medical Professional 55 0 X 462653 0 48410 Jack Mahdasian Medical Staff 55 0 X 459506 0 50504 Samuel Lin Medical Staff 55 0 X 461904 0 43171 Sonia Motin Medical Staff 55 0 X 443638 0 49010 Louis Nykamp Medical Staff 55 0 X 427874 0 42891 Paul H Karsten VP & CFO 58 2 X 413705 0 47356 Robert L Nykamp VP & COO 60 0 X 396828 0 32682 Valerie MathisAllen Medical Staff 55 0 X 302353 0 41104 Harmony Gould Director of HBS 60 0 X 274847 0 32604 Susan Langeland Chief Information Officer 60 0 X 268528 0 31172 Thomas Scott Halstead Director of PPG 60 0 X 190095 0 51407 Ryan LaRue Vice President of Contracts 55.00 0 X 156491 0 37563 Jody Vanderwel Chairperson 2 0 X 0 0 0 Douglas Josephson Vice Chairperson & Secretary 4 0 X 0 0 0 Gil Segovia Treasurer 2 0 X 0 0 0 Mina Breuker Board Member 1 0 X 0 0 0 Mary Ann Cartwright Board Member 1 0 X 0 0 0 Robert Connors Board Member 1 0 X 0 0 0 Jack DeBoer Board Member 1 0 X 0 0 0 Steve Ender Board Member 1 0 X 0 0 0 Stacia Ford-Spicer Board Member 1 0 X 0 0 0 Brett Holleman Board Member 1 0 X 0 0 0 Marilyn Litka-Klein Board Member 1 0 X 0 0 0 Stella Michael Board Member 1 0 X 0 0 0 David McKeague Board Member 1 0 X 0 0 0 Michael Ramirez Board Member 1 0 X 0 0 0 Abbey Slakick Board Member 1 0 X 0 0 0 Susan Valcq Board Member 1 0 X 0 0 0 Sherita Washington Board Member 1 0 X 0 0 0 7010620 0 746372 230 1 1 0 Comphealth Associates Inc 7259 S Bingham Junction Blvd Midvale UT 84047 Medical Staffing 2670145 US Signal LLC 201 Ionia Avenue SW Grand Rapids MI 49503 Cloud Data Hosting 2131175 Epic Systems Corporation 1979 Milky Way Verona WI 53593 Electronic Medical Record 1774438 Forefront healthcare LLC 22622 Harper Ave St Clair Shores MI 48080 Food Service 1668400 Institutional Pharmacy Solutions 3480 EAstern Boulevard Montgomery AL 36116 Pharmacy 1218349 46 0 0 0 3436910 1225825 13060653 0 17723388 Inpatient Care 622210 107121765 107121765 0 0 Outpatient Clinics 621420 78639731 78639731 0 0 Residential Care 623200 20385865 20385865 0 0 Other Patient Revenue 624100 1850110 1850110 0 0 0 0 0 0 207997471 1932605 0 0 1932605 0 0 0 0 0 0 0 0 14571 0 6185 0 8386 0 8386 0 0 8386 21823811 0 19352254 0 2471557 0 2471557 0 0 2471557 0 Rustic Market Sales 455000 388032 388032 0 0 Medical Record Transcription 624100 156550 156550 0 0 CARES Act Provider Relief 620000 29386 29386 0 0 116412 116412 0 0 690380 230823787 208687851 0 4412548 0 0 0 0 0 0 0 0 7010620 4140713 2869907 0 0 0 0 0 129562265 114821552 14309203 431510 0 0 0 0 24544988 20755731 3702065 87192 0 0 0 0 0 0 0 0 464082 95928 368154 0 186665 0 186665 0 85500 0 85500 0 0 0 202818 0 202818 0 17268113 12824786 4385429 57898 1251555 70603 1156975 23977 1226286 778903 418203 29180 5731740 34513 5696834 393 0 0 0 0 4368594 3616164 727974 24456 293377 186591 101079 5707 0 0 0 0 0 0 0 0 1567826 0 1567826 0 0 0 0 0 7668034 3628308 4013748 25978 795830 0 795830 0 Food Expense 3890548 3830528 59936 84 QAAP 3721639 3721639 0 0 Patient Assistance Support 2094878 2094878 0 0 Pharmacy Costs 1474059 1474059 0 0 3968225 2182963 1766547 18715 217377642 174257859 42414693 705090 490139 1729097 0 0 199609 35746 19218001 19138297 80000 70000 0 0 0 0 193411 0 6734755 11729983 171471958 104442068 53222530 67029890 31426936 34370999 0 0 3092186 0 0 0 12996539 11065213 127654106 145169225 18719715 21189030 0 0 265965 437216 23420000 20820000 0 0 0 0 0 0 609358 500000 10973042 12639186 53988080 55585432 X 72702075 86148220 963951 3435573 73666026 89583793 127654106 145169225 X 13446145 0 0 0 0 2471622 X 0 1 X 1 1 1 X 0 0 0 0 0 0 1 85500 0 0 85500 0 Schedule C, Part II-B, Line 1 Verbal and written communication with public officials regarding legislation and proposals affecting the delivery of healthcare in Michigan and Nationally. 25595067 39324 3116509 662198 136018 0 27952684 24395211 86064 3193427 1986096 93539 0 25595067 30454204 123914 -4707914 1360139 114854 0 24395211 26104515 117946 5332485 1094565 6177 0 30454204 25715850 127880 1481591 1219787 1019 0 26104515 0.85 0.15 0 0 1 1 0 441920 441920 0 88400253 53550958 34849295 0 7043352 2922035 4121317 0 57410522 43607091 13803431 0 18175911 4361984 13813927 67029890 Deferred Compensation 4448191 Operating Lease Right of Use Asset 4383898 Other Assets 2233124 11065213 0 Deferred Compensation 4448191 Finance Lease Obligations, net of current portion 4430739 Operating lease liability, net of current portion 3760256 12639186 X 230627154 0 0 0 0 0 230627154 202818 -6185 196633 230823787 217181009 0 0 0 6185 6185 217174824 202818 0 202818 217377642 Schedule D, Part V, Line 4 The spending policy allows for annual spending of 5% of the average fair market value of the net assets for the prior three years. This amount is transferred from the Foundation to the operating funds of the Pine Rest organization to provide for the care of patients and initiatives that benefit the organization. The spending policy allows for use of investment earnings on restricted endowment funds in accordance with donor wishes. Schedule D, Part X, Line 2 The Corporation is a non-profit hospital corporation organized under the laws of the State of Michigan and is designated by the Internal Revenue Service as a section 501(c)(3) organization. It is exempt from income taxes on related income pursuant to Section 501(a) of the Internal Revenue Code. The Corporation has no amounts accrued for interest penalties as of June 30, 2024. The Corporation does not expect the total amount of unrecognized tax benefits to significantly change over the next twelve months. The Corporation is no longer subject to examination by tax authorities for years before 2019. Schedule D, Part XI, Line 4b $6,185 equals rental expense that is reported in expenses on audited financial statements but reported in net revenue on IRS 990 Schedule D, Part XII, Line 2d $6,185 is Rental expense that is reported in expense in the audited financial statements but netted against revenue in the IRS 990. 1 1 X 1 X 2.5 1 X 1 1 0 0 5273238 1116000 4157238 0.0239 46090165 36368143 9722022 0.0558 0 0 0 0 0 0 51363403 37484143 13879260 0.0797 162102 0 162102 0.0007 0 0 0 0 56037733 43051997 12985736 0.0598 641852 338003 303849 0.0014 0 0 0 0 0 0 56841687 43390000 13451687 0.0619 0 0 108205090 80874143 27330947 0.1416 0 5594954 191168 26937310 29515490 -2578180 X 1 1 1 1 Pine Rest Christian Mental Health Services 300 68th Street SE PO Box 165 Grand Rapids MI 495010165 www.pinerest.org X Pine Rest Christian Mental Health Services 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X https://www.pinerest.org/about-us/ X https://kentcountyhealthconnect.org/community-health-needs-assessment/2023-chna/ 1 24 1 https://www.pinerest.org/media/CHIP-2024.pdf 0 0 1 X 1 1 X X X X 1 X https://www.pinerest.org/community-services-outreach/financial-assistance/ X https://www.pinerest.org/community-services-outreach/financial-assistance/ X https://www.pinerest.org/community-services-outreach/financial-assistance/ X X X X X X 1 X 0 X X X X 0 X X X X 0 0 Schedule H, Part V, Section B, Line 5-Pine Rest Christian Mental Health Services The process of assessing community health needs in Kent County, Michigan is undertaken on a collaborative basis. The process (CHNA) is organized and coordinated by the Kent County Department of Public Health every three years. The process involves more than fifty community organizations, including acute care health systems and specialty hospitals in the county. Pine Rest Christian Mental Health Services is a principal participant in the CHNA process, especially as it relates to behavioral health in all aspects. Through community engagement and participation, this process identifies and prioritizes health-related needs and analyzes a broad range of social, economic, environmental and behavioral factors that may contribute to health needs or influence health outcomes of residents. The process involves collection of information from the public at-large through focus groups, meetings, and surveys. Information from the CHNA process is then used to develop a Community Health Improvement Plan (CHIP), which aims to address the prioritized needs. The final CHIP, compiled by the Department of Public Health with the assistance of all major participants, is made available to the public on the Department's website. See https://kentcountyhealthconnect.org/community-health-needs-assessment/2023-chna/. See the CHIP for details on methods employed, data collected, sources of input, and key findings. Pine Rest Christian Mental Health Services uses the CHIP to establish its own strategic initiatives addressing the needs identified in the behavioral health field. See https://www.pinerest.org/about-us/#KCCNA Schedule H, Part V, Section B, Line 6a-Pine Rest Christian Mental Health Services Kent County Health Department, Mary Free Bed Rehabilitation Hospital, Trinity Health, University of Michigan Health West, Corewell Health. Schedule H, Part V, Section B, Line 6b-Pine Rest Christian Mental Health Services https://kentcountyhealthconnect.org/community-health-needs-assessment/2023-chna/ for a full list of participants. Schedule H, Part V, Section B, Line 11-Pine Rest Christian Mental Health Services For each year of the CHNA, Pine Rest assesses and builds a response to the report. Consequently, Pine Rest Christian Mental Health Services has selected issues from the CHNA that can and should be addressed by the organization. Schedule H, Part V, Section B, Line 13h-Pine Rest Christian Mental Health Services In determining financial assistance eligibility, Pine Rest Christian Mental Health Services evaluates the patient/guarantor's ability to pay the organization for the services requested or previously provided. Pine Rest evaluates information such as: income, net worth, employment status, other financial obligations and amount/frequency of healthcare needs. Schedule H, Part V, Section B, Line 21c-Pine Rest Christian Mental Health Services Pine Rest Christian Mental Health Services is a behavioral health facility. Emergency Medical care is not provided at the organization and therefore the organization does not fall under EMTALA. Schedule H, Part V, Section B, Line 21d-Pine Rest Christian Mental Health Services Pine Rest Christian Mental Health Services is a behavioral health facility. Emergency Medical care is not provided at the organization and therefore the organization does not fall under EMTALA. 28 Pine Rest - Campus Clinic 300 68th Street SE PO Box 165 Grand Rapids MI 495010165 Outpatient clinic, residential detox, screening, assessment, referral Pine Rest - Southwest Clinic 4211 Parkway Place Grandville MI 49418 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Traverse City Clinic 1050 Silver Drive Traverse City MI 49684 Outpatient Clinic, mental health, addiction treatment and follow up Pine Rest - Northeast Clinic 3225 North Evergreen Drive NE Suite 301 Grand Rapids MI 49525 Outpatient Clinic, screening, assessment, referal and follow up Pine Rest - Northwest Clinic 2118 3 Mile Road Grand Rapids MI 49544 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Northshore Clinic 17325 VanWagoner Road Spring Lake MI 49456 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Neuromodulation Clinic ECT/TMS 300 68th Street SE Grand Rapids MI 49508 Outpatient and Inpatient, screening, assessment, referral and follow up Pine Rest - Christian Counseling Center 1870 Leonard NE Grand Rapids MI 49505 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - InterActions Residential Treatment 300 68th Street SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Recovery 300 68th Street SE Grand Rapids MI 49548 Residential mental health and addiction treatment and detox Pine Rest - Holland Clinic 926 S Washington Ave Suite 210 Holland MI 49423 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Kalamazoo Clinic 1530 Nichols Road Kalamazoo MI 49006 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Community Case Management 320 Commerce Avenue SW Grand Rapids MI 49503 Outpatient Clinic, comm change alternative informatin training, prevention and mental health Pine Rest - Zeeland Clinic 8333 Felch Suite 210 Zeeland MI 49464 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Caledonia Clinic 6505 Cherry Meadow Dr Caledonia MI 49316 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - CenterPointe Recovery Center 1145 Oakland Drive Kalamazoo MI 49008 Adult Foster Care Pine Rest - Cameron 6680 Adrian SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - SEQUOIA Program 300 68th Street SE Grand Rapids MI 49548 Education, awareness, access and non-traditional services to the community Pine Rest - Westwood 7047 Madison SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Pine Grove 7051 Madison SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Portage Clinic 1350 W Centre Avenue Portage MI 49024 Outpatient Clinic, screening, assessment, referral and follow up Pine Rest - Adrian 6700 Adrian SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Eastwood 7041 Madison SE Grand Rapids MI 49548 Adult Foster Care Pine Rest - Supported Independent Living 821 68th Street SE Grand Rapids MI 49508 Residential supervised independent living Pine Rest - Forest Hills Clinic 877 Forest Hill Ave SE Grand Rapids MI 49546 Outpatient clinic, residential detox, screening, assessment, referral Pine Rest - Hastings Clinic 450 Meadow Run Hastings MI 49058 Outpatient clinic, residential detox, screening, assessment, referral Pine Rest - Transition Clinic 300 68th Street SE Grand Rapids MI 49548 Assist youth in transitioning from Foster care Pine Rest - Psychological Consultation Center 6500 Byron Center Ave SW Suite 300 Byron Center MI 49315 Specializes in assessing the relationship between behavior and brain functioning. Schedule H, Part I, Line 7 Utilizing prescribed worksheets 1 through 8 as defined by the IRS Schedule H, Part III, Section A, Line 4 The provision for bad debit is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in healthcare coverage and other collection indicators. Accounts receivables are written off and charged to bad debt after collection efforts have been made in accordance with organizational policies. Recoveries are treated as a reduction of bad debt. Accounts receivables are reduced by an allowance for doubtful accounts. The allowances for doubtful accounts are reviewed frequently based upon historical data regarding collections. Schedule H, Part III, Section B, Line 8 The sources is the Medicare cost report as well as fiscal year-end organization financial statements and data. Schedule H, Part III, Section C, Line 9b The organization's financial assistance policy and collection policies address the circumstances in which "extraordinary collection action" will be taken with regard to a patient who is or may be eligible for financial assistance. In summary, as long as a patient is eligible to apply for financial assistance (a period that remains open for a minimum of 240 days from the date of initial billing statement), no extraordinary collection action will be taken. If a patient submits a complete financial assistance application during the application period, Pine Rest will not engage in any extraordinary collection action during application processing. Outstanding patient balances owed and not covered by the Financial Assistance Program may be subject to extraordinary collection action. However, uninsured patients whose annual income is less than or equal to 250% of the federal poverty guidelines and who do not qualify for financial assistance will qualify to have their charges reduced to Medicare rates for the same or similar services. Payment of the adjusted charges will be considered payment in full for the billed services. The collection policy can be consulted for complete details. hppts://pinerest.org/media/Billing-Collections-Policy.pdf Schedule H, Part VI, Line 2 Each year, Pine Rest Christian Mental Health Serivces reviews and builds a response to the most recent Community Health Needs Assessment (CHNA) and ensures that we are addressing community need as best we can. Further, the planning process takes into account market demand and the needs of the greater medical community in assessing how to organize clinical care delivery. The organizations annual budget process ensures that it is performing these services in a financially sustainable manner. Schedule H, Part VI, Line 3 Pine Rest has implemented measures to communicate to patients, their family members, and the public the availability of both public and private financials assistance. Communication methods include but are not limited to written information in all admission offices, waiting rooms and other public locations, as well as information on the Pine Rest website. In addition, Pine Rest offers a plain language summary of its Financial Assistance Eligibility Policy as part of the patient intake and/or discharge process and provides individuals with assistance in completing the application. The Financial Assistance Eligibility Police, Plain Language Summary and Application Form are available in fourteen languages. Schedule H, Part VI, Line 4 Our hospital and residential campus is located in Cutlerville, Michigan and primarily services people living in the greater West Michigan area. Some of the programs, especially those serving children and adolescents, draw from a larger geographic area. Through our growing telehealth services, the organizations clinical reach continues to expand. The network of inpatient, residential, and outpatient services reaches people of all ages, races, ethnicities and walks of life. Schedule H, Part VI, Line 5 To ensure a strategic focus on the health needs of the community serviced, the majority of the governing body is composed of residents of the primary service area of the organization. These individuals are neither employees nor contractors of the organization. In addition, the organization has an open medical staff, allowing hospital staff membership to all physicians in the community who meet membership and clinical privilege requirements. This approach improves access to behavioral health services through greater availability of medical staff within the service area. Since 1910, the organization has consistently applied surplus funds to the improvement of patient access and care, staff education and research designed to expand and improve the level of patient care. Pine Rest also provides educational programs to the community on behavioral health topics. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 Mark C Eastburg PhD President & CEO 470447 0 122680 0 20435 0 30000 0 27510 0 671072 0 0 0 Marwan Tabbara Medical Staff 483053 0 104250 0 713 0 29309 0 20710 0 638035 0 0 0 William Sanders Chief Medical Officer 356787 0 175851 0 23213 0 22500 0 26510 0 604861 0 0 0 Lindsey Bailey Medical Staff 229810 0 267815 0 22458 0 22500 0 10449 0 553032 0 0 0 Bibhas Singla Medical Staff 290871 0 162251 0 21564 0 22500 0 26510 0 523696 0 0 0 James Eicher Medical Professional 300036 0 140744 0 21873 0 22500 0 25910 0 511063 0 0 0 Jack Mahdasian Medical Staff 305435 0 134371 0 19700 0 26746 0 23758 0 510010 0 0 0 Samuel Lin Medical Staff 305567 0 155693 0 644 0 22500 0 20671 0 505075 0 0 0 Sonia Motin Medical Staff 351256 0 91888 0 494 0 22500 0 26510 0 492648 0 0 0 Louis Nykamp Medical Staff 349987 0 62621 0 15266 0 22220 0 20671 0 470765 0 0 0 Paul H Karsten VP & CFO 330351 0 82672 0 682 0 29443 0 17913 0 461061 0 0 0 Robert L Nykamp VP & COO 304138 0 69477 0 23213 0 30000 0 2682 0 429510 0 0 0 Valerie MathisAllen Medical Staff 218609 0 60600 0 23144 0 30000 0 11104 0 343457 0 0 0 Harmony Gould Director of HBS 211460 0 62831 0 556 0 22500 0 10104 0 307451 0 0 0 Susan Langeland Chief Information Officer 216876 0 51060 0 592 0 5512 0 25660 0 299700 0 0 0 Thomas Scott Halstead Director of PPG 164533 0 25128 0 434 0 29704 0 21703 0 241502 0 0 0 Ryan LaRue Vice President of Contracts 139781 0 16343 0 367 0 11873 0 25690 0 194054 0 0 0 Schedule J, Part I, Line 1a taxable term life premiums added to taxable income were grossed up to compensate for taxes on the premiums. Grossed up amounts were taxed. Schedule J, Part I, Line 3 The Board of Directors has adopted a written executive compensation plan and has delegated to the Compensation Committee the responsibility for implementing and overseeing compensation issues with regular reporting to the board. In setting and reviewing executive compensation for the COO, CFO, CMO and Vice Presidents, the Compensation Committee relies on market data for similarly situated hospital executives in comparable organizations. The Compensation Committee also reviews salary market information for the CEO and makes a recommendation to the Executive Committee. The Executive Committee relies on market data for similarly situated professionals serving comparable institutions. The organization regularly commissions studies by ECG Management to ensure that the total compensation paid to Physicians is reasonable, consistent with objective market data and in the best interest of the organization. The compensation model for Physicians was adopted by the organization based upon those studies. Review and approval of all new Physician employment contracts by both the CFO and chairman of the Compensation Committee is required to ensure that all compensation packages are within the approval limits. Documentation and supporting detail are maintained for all compensation decisions. Schedule J, Part I, Line 7 Employment contracts with officers of the organization allow for performance-based incentives. Each year, the Board of Directors articulates and approves objective, measurable performance criteria. If performance criteria are met, performance-based incentives are paid. A Kent Hospital Finance Authority 382350002 2022-03-25 28120000 Refinance 2015 and 2017 Bonds 0 0 0 A 0 0 0 0 0 0 0 0 0 0 0 0 2031 1 0 0 1 A 0 0 0 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 1 William Sanders Chief Medical Officer X 100000 70000 0 1 1 70000 Form 990, Part VI, Section B, Line 11b The Board of directors has authorized the Finance Committee of the Board of Directors to review and approve form 990 each year prior to submission to the IRS. Each year, a copy of the Form 990 is given to the external auditors for review. Recommended changes are made to the form and supporting schedules. The Finance Committee votes on a motion to approve the form as amended. The final filed 990 is made available to all Board members for their review and information. Form 990, Part VI, Section B, Line 12c Every year, each member of the Board of Directors, as well as every officer and key employee, completes and certifies a written conflict-of-interest statement. The statement requires acknowledgment of the written conflict-of-interest policy and disclosure of any transaction or relationship falling within the policy. The organization's independent auditors also review transactions for conflicts of interest as part of the annual audit. The organization employs a director of corporate integrity, whose responsibilities include discovery and reporting of all actual and potential conflicts of interest. Form 990, Part VI, Section B, Line 15 The Board of Directors has adopted a written executive compensation plan and has designated to the Compensation Committee the responsibility for implementing and overseeing the plan, with regular reporting to the board. In setting and reviewing executive compensation for the CMO, COO, CFO and Vice Presidents, the Compensation Committee relies on market data for similarly situated hospital executives in comparable institutions. The Compensation Committee also reviews salary market information for the CEO and makes recommendations to the Executive Committee. The Executive Committee oversees CEO compensation. In setting and reviewing compensation of physicians (both employed and independently contracted), the Compensation Committee relies on market data for similarly situation professionals serving in comparable institutions. The Corporation regularly commissions studies by ECG Management Consultants to ensure that the total compensation paid to physicians is reasonable, consistent with objective market data, and in the best interest of the Corporation. The compensation model for physicians adopted by the Corporation is based on these studies. Review and approval of all new physician employment contracts by both the CFO and the Chairperson of the Compensation Committee is required to ensure that the compensation packages are within approved limits. Documentation and supporting detail are maintained for all compensation decisions. Form 990, Part VI, Section C, Line 19 Available upon request. Form 990, Part XI, Line 9 Changes in net assets with donor restrictions equals contributions restricted by donors of $3,826,470 less Net assets released from restriction of $1,354,848 for a total of $2,471,622 Pine Rest Foundation 300 68th Street SE PO Box 165 Grand Rapids MI 495011065 381676540 Fundraising MI 501(c)(3) Type 1 Pine Rest Christian Mental Health Services 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 Pine Rest Foundation c 792077 Each year, following a specific formula, the Pine Rest Foundation awards grants to Pine Rest Christian Mental Health Services to fund various aspects of behavioral healthcare and counseling programs along with patient assistance. Pine Rest Foundation p 71878 Pine Rest Christian Mental Health Services accounts payable department processes all invoices for the Pine Rest Foundation. The Pine Rest Foundation then reimburses Pine Rest Christian Mental Health Services for the amount equal to those invoices processed and paid on their behalf. We filed and had accepted an 8868 extension on this report to May 15, 2025.