HOLLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- HOLLAND COMMUNITY HEALTH CENTER (EIN 20-0602574)
- Tax period
- 2022-04-01 to 2023-03-31
- Filed
- 2024-02-15
- IRS object ID
- 202440469349302114
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-02-15T13:08:02-06:00 | ReturnTs |
| Tax Period End | 2023-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2601 CAMBRIDGE CT STE 300 | AddressLine1Txt |
| City | AUBURN HILLS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48326 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200602574 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLLAND COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOLL | BusinessNameControlTxt |
| Phone | 6163943788 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 336 S RIVER AVE | AddressLine1Txt |
| City | HOLLAND | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49423 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALEX ROEHLING | PersonNm |
| Person Title | VICE PRESIDENT & CFO | PersonTitleTxt |
| Phone | 6163943788 | PhoneNum |
| Signature | 2024-02-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALEX | PersonFirstNm |
| Person Last | ROEHLING | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 2483757100 | PhoneNum |
| Preparation | 2024-02-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALEX ROEHLING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 336 S RIVER AVE | AddressLine1Txt |
| City | HOLLAND | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49423 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,664,993 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESS TO QUALITY PRIMARY HEALTH CARE FOR ALL MEMBERS OF THE COMMUNITY WITH BOTH RESPECT AND COMPASSION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $106,253 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,040,148 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $392,838 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,624,845 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $499,097 | PYTotalRevenueAmt |
| CY Total Revenue | $2,664,993 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $499,097 | PYOtherExpensesAmt |
| CY Other Expenses | $2,664,993 | CYOtherExpensesAmt |
| PY Total Expenses | $499,097 | PYTotalExpensesAmt |
| CY Total Expenses | $2,664,993 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $0 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $655,155 | TotalAssetsBOYAmt |
| Total Assets EOY | $290,533 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $655,155 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $290,533 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH OF THE PATIENTS IN THE HOLLAND COMMUNITY BY PROVIDING QUALITY HEALTH CARE REGARDLESS OF LANGUAGE, FINANCIAL OR CULTURAL BARRIERS; THEREBY ASSURING THAT PRIMARY HEALTH CARE IS ACCESSIBLE TO ALL RESIDENCE TO OF THE AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,569,351 | ExpenseAmt |
| Revenue | $1,624,845 | RevenueAmt |
| Desc | PROVIDED PATIENT HEALTH CARE VISITS TO APPROXIMATELY 4,684 PATIENTS | Desc |
| Total Program Service Expenses | $2,569,351 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEXANDER ROEHLING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6163943456 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 602 MICHIGAN AVE | AddressLine1Txt |
| City | HOLLAND | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49423 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| DALE M SOWDERS | |||||||
| PRESIDENT-CEO | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $786,416 | $22,480 |
| DAVE MASON | |||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SHELLY MACIEJEWSKI | |||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JUANITA BOCANEGRA | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL HILL | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BILL VANDER VLIET MD | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GWEN AUWERDA | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LESLIE BROWN | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KEN FILIPPINI | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GREG CHRISTIE | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DOUG HOEY | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BARBARA DEPREE MD | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $169,716 | $17,310 | |
| HAANS MULDER | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| STEPHEN MAUGER | |||||||
| TRUSTEE - PART YEAR | 1.00 | 40.00 | Yes (X) | $0 | $554,481 | $26,714 | |
| ALEX ROEHLING | |||||||
| VP, FINANCE & CFO | 1.00 | 40.00 | Yes (X) | $0 | $301,623 | $7,769 | |
| MARK L PAWLAK | |||||||
| SVP, QUALITY, IS & HOSP OP | 1.00 | 40.00 | Yes (X) | $0 | $580,861 | $17,327 | |
| PATTI VANDORT | |||||||
| SVP, CNO, REHAB SERV, MARK | 1.00 | 40.00 | Yes (X) | $0 | $555,272 | $15,838 | |
| JOSEPH D BONELLO | |||||||
| VICE PRESIDENT, NURSING-CNO | 1.00 | 40.00 | Yes (X) | $0 | $269,814 | $24,737 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,218,183 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $132,175 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECTRUM HEALTH MEDICAL GROUP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 648 MONROE NW SUITE 300 | AddressLine1Txt |
| City | GRAND RAPIDS | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MANAGEMENT SERVICES | ServicesDesc |
| Compensation | $117,743 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $740,782 | RelatedOrganizationsAmt |
| All Other Contributions | $299,366 | AllOtherContributionsAmt |
| Total Contributions | $1,040,148 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 621400 | $1,355,928 | $1,355,928 |
| PHYSICIAN INCENTIVES | 621400 | $268,917 | $268,917 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,624,845 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,664,993 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,624,845 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,053,034 | TotalAmt |
| Program Services | $2,011,577 | ProgramServicesAmt |
| Management And General | $41,457 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,185 | TotalAmt |
| Management And General | $54,185 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $328,401 | TotalAmt |
| Program Services | $328,401 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,499 | TotalAmt |
| Program Services | $5,499 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,212 | TotalAmt |
| Program Services | $8,212 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES AND DR | $164,003 | $164,003 |
| BAD DEBT EXPENSE | $51,659 | $51,659 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,664,993 | TotalAmt |
| Program Services | $2,569,351 | ProgramServicesAmt |
| Management And General | $95,642 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,216 | BOYAmt |
| EOY | $68,967 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,854 | BOYAmt |
| EOY | $185,629 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,864 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,927 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,085 | BOYAmt |
| EOY | $35,937 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $655,155 | BOYAmt |
| EOY | $290,533 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $619,638 | BOYAmt |
| EOY | $90,802 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,517 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $199,731 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $655,155 | BOYAmt |
| EOY | $290,533 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $655,155 | BOYAmt |
| EOY | $290,533 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $0 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,864 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,927 | DepreciationAmt |
| Book Value | $35,937 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $35,937 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RELATED PARTY PAYABLE | Desc |
| Amt | $199,731 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $199,731 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DALE M SOWDERS | ||||||||||||||
| PRESIDENT-CEO | $0 | $766,445 | $0 | $0 | $0 | $19,971 | $0 | $9,150 | $0 | $13,330 | $0 | $808,896 | $0 | $0 |
| MARK L PAWLAK | ||||||||||||||
| SVP, QUALITY, IS & HOSP OP | $0 | $422,611 | $0 | $45,090 | $0 | $113,160 | $0 | $9,130 | $0 | $8,197 | $0 | $598,188 | $0 | $0 |
| STEPHEN MAUGER | ||||||||||||||
| TRUSTEE - PART YEAR | $0 | $285,002 | $0 | $192,670 | $0 | $76,809 | $0 | $9,150 | $0 | $17,564 | $0 | $581,195 | $0 | $0 |
| PATTI VANDORT | ||||||||||||||
| SVP, CNO, REHAB SERV, MARK | $0 | $444,822 | $0 | $91,679 | $0 | $18,771 | $0 | $9,130 | $0 | $6,708 | $0 | $571,110 | $0 | $0 |
| ALEX ROEHLING | ||||||||||||||
| VP, FINANCE & CFO | $0 | $242,895 | $0 | $50,797 | $0 | $7,931 | $0 | $7,417 | $0 | $352 | $0 | $309,392 | $0 | $0 |
| JOSEPH D BONELLO | ||||||||||||||
| VICE PRESIDENT, NURSING-CNO | $0 | $236,713 | $0 | $28,110 | $0 | $4,991 | $0 | $7,101 | $0 | $17,636 | $0 | $294,551 | $0 | $0 |
| BARBARA DEPREE MD | ||||||||||||||
| TRUSTEE | $0 | $123,271 | $0 | $25,300 | $0 | $21,145 | $0 | $4,158 | $0 | $13,152 | $0 | $187,026 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION SHALL HAVE TWO CLASSES (CLASS H AND CLASS P) OF MEMBERS. THERE SHALL BE ONE CLASS H MEMBER, HOLLAND COMMUNITY HOSPITAL, A MICHIGAN NONPROFIT CORPORATION, OF HOLLAND, MICHIGAN. THE CLASS P MEMBERS SHALL BE LIMITED TO MICHIGAN NONPROFIT CORPORATIONS ORGANIZED AND OPERATED FOR THE EMPLOYMENT OF PHYSICIANS, PHYSICIAN-OWNED PROFESSIONAL CORPORATION OR LIMITED LIABILITY COMPANIES, OR OTHER PHYSICIAN GROUPS PRACTICING IN THE HOLLAND, MICHIGAN AREA. APPLICATION FOR MEMBERSHIP SHALL BE SUBMITTED ON FORMS APPROVED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL APPROVE OR REJECT APPLICATIONS FOR MEMBERSHIP; PROVIDED, HOWEVER, THAT IF A VOTE ON ANY SUCH MATTER RESULTS IN A TIE, THE CLASS H MEMBER SHALL HAVE THE RIGHT TO MAKE THE FINAL DECISION ON THE ADMISSION OF THE NEW MEMBER. MEMBERSHIP IN THE CORPORATION SHALL BE PERPETUAL FROM THE DATE OF ACCEPTANCE OF THE MEMBER'S APPLICATION FOR MEMBERSHIP, UNLESS THE MEMBER RESIGNS, DISSOLVES, OR IS EXPELLED. ANY SUCCESSOR ORGANIZATION BY WAY OF A MERGER OR OTHER REORGANIZATION OF A MEMBER SHALL CONTINUE AS A MEMBER OF THE CORPORATION AUTOMATICALLY WITHOUT FURTHER ACTION ON THE PART OF THE MEMBER OR THE CORPORATION. A MEMBER MAY BE EXPELLED BY ACTION OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE; PROVIDED, HOWEVER, THAT IF THE VOTE ON ANY SUCH MATTER RESULTS IN A TIE, THE CLASS H MEMBER SHALL HAVE THE RIGHT TO MAKE THE FINAL DECISION ON THE EXPULSION OF ANY MEMBER. EACH MEMBER SHALL BE ENTITLED TO VOTE ON ANY MATTER FALLING UNDER THE AUTHORITY OF THE MEMBERS AS ESTABLISHED BY THE ARTICLES OF INCORPORATION, THE BY-LAWS OF THE CORPORATION, OR BY LAW. ON ANY MATTER ON WHICH THE MEMBERS ARE VOTING, THE CLASS H MEMBER SHALL HAVE ONE VOTE AND THE CLASS P MEMBERS SHALL COLLECTIVELY HAVE ONE VOTE, SUCH VOTE TO BE DETERMINED BY MAJORITY VOTE AMONG THE CLASS P MEMBERS WITH EACH CLASS P MEMBER HAVE A NUMBER OF VOTES EQUAL TO THE NUMBER OF FULL TIME EQUIVALENT PHYSICIANS EMPLOYED BY OR OWNERS (PARTNERS, CO-MEMBERS, OR SHAREHOLDERS) OF THE CLASS P MEMBER AND PRACTICING IN THE HOLLAND, MICHIGAN AREA. IN ALL OTHER RESPECTS, EACH MEMBER SHALL HAVE IDENTICAL RIGHTS AND PRIVILEGES, WITHOUT RESPECT TO CLASS, EXCEPT AS MAY BE PROVIDED FOR IN THE BY-LAWS OF THE CORPORATION AUTOMATICALLY WITHOUT FURTHER ACTION ON THE PART OF THE MEMBER OR THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS SHALL ELECT THE BOARD OF DIRECTORS. THE BOARD SHALL AT ALL TIMES CONSIST OF SIX DIRECTORS, THREE OF WHOM SHALL BE ELECTED BY THE CLASS H MEMBER AND THREE OF WHOM SHALL BE ELECTED BY THE CLASS P MEMBERS BY A COLLECTIVE VOTE AMONG THE CLASS P MEMBERS. THE TERM OF EACH DIRECTOR SHALL BE PERPETUAL, SUBJECT TO THE RESIGNATION AND REMOVAL PROVISIONS PROVIDED FOR. A DIRECTOR MAY RESIGN BY WRITTEN NOTICE TO THE CORPORATION SECRETARY. THE MEMBERS WHO APPOINTED OR ELECTED A DIRECTOR MAY REMOVE THE DIRECTOR WITH OR WITHOUT CAUSE UPON THE SAME VOTE REQUIRED FOR ELECTION. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITHIN THE GOVERNING BODY |
| FORM 990, PART VI, SECTION B, LINE 11B | HOLLAND COMMUNITY HOSPITAL'S CFO, PRESIDENT AND CEO REVIEW THE FORM 990 PRIOR TO FILING. THE CEO THEN SIGNS AND FILES THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS, ADMINISTRATION, DIRECTORS AND MANAGERS FILL OUT A CONFLICT OF INTEREST DISCLOSURE FORM ANNUALLY. THESE FORMS ARE COLLECTED BY THE COMPLIANCE OFFICE, INVESTIGATED AND THEN MAINTAINED BY HUMAN RESOURCES. THE BYLAWS SPECIFICALLY STATE THAT A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST AS TO A MATTER BEFORE THE BOARD SHOULD NOT VOTE OR USE PERSONAL INFLUENCE WITH OTHER BOARD MEMBERS. THE MINUTES OF THE BOARD MEETING SHALL DISCLOSE THE MEMBER'S ABSTINENCE FROM VOTING ON THE MATTER. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
| FORM 990, PART IX, LINE 11G | PURCHASED MAINTENANCE: PROGRAM SERVICE EXPENSES 76,892. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,892. OTHER CLINICAL SERVICES: PROGRAM SERVICE EXPENSES 1,020. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,020. OUTSIDE SERVIES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 41,457. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,457. LEASED EMPLOYEES: PROGRAM SERVICE EXPENSES 1,933,665. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,933,665. |
| FORM 990, PART VI, SECTION B, LINE 13-14: | HCHC DOES NOT HAVE A FORMAL WRITTEN WHISTLEBLOWER POLICY OR WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. THEY ADHERE TO THE POLICIES THAT HAVE BEEN SET FORTH BY HOLLAND COMMUNITY HOSPITAL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HOLLAND COMMUNITY HOSPITAL | |||||||||||
| 602 MICHIGAN AVENUE | HOLLAND | MI | 49423 | 382800065 | HOSPITAL CARE | MI | 501(C)(3) | HOSPITAL | N/A | 0 | |
| HOLLAND COMMUNITY HOSPITAL AUTHORITY SELF-INSURANCE TRUST FUND | |||||||||||
| 602 MICHIGAN AVENUE | HOLLAND | MI | 49423 | 386389385 | SUPPORTING ORGANIZATION | MI | 501(C)(3) | LINE 12A, I | Yes (1) | HOLLAND COMMUNITY HOSPITAL | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLLAND COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $740,782 | InvolvedAmt |
| Method Of Amount Determination | PAYMENT RECEIVED AND DUE | MethodOfAmountDeterminationTxt |