2024-02-15T13:08:02-06:00 2023-03-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2022-04-01 200602574 HOLLAND COMMUNITY HEALTH CENTER HOLL 6163943788 336 S RIVER AVE HOLLAND MI 49423 ALEX ROEHLING VICE PRESIDENT & CFO 6163943788 2024-02-14 1 ALEX ROEHLING 999009999 1 DAVID LOWENTHAL P00378651 2483757100 2024-02-14 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALEX ROEHLING 336 S RIVER AVE HOLLAND MI 49423 2664993 0 X N/A X 2004 MI TO PROVIDE ACCESS TO QUALITY PRIMARY HEALTH CARE FOR ALL MEMBERS OF THE COMMUNITY WITH BOTH RESPECT AND COMPASSION. 13 11 0 1 0 0 106253 1040148 392838 1624845 0 0 6 0 499097 2664993 0 0 0 0 0 0 0 0 0 499097 2664993 499097 2664993 0 0 655155 290533 655155 290533 0 0 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. 0 0 2569351 1624845 PROVIDED PATIENT HEALTH CARE VISITS TO APPROXIMATELY 4,684 PATIENTS 2569351 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 0 1 0 0 0 0 1 1 1 1 1 0 0 0 MI X ALEXANDER ROEHLING 6163943456 602 MICHIGAN AVE HOLLAND MI 49423 DALE M SOWDERS PRESIDENT-CEO 1.00 40.00 X X 0 786416 22480 DAVE MASON CHAIR 1.00 1.00 X X 0 0 0 SHELLY MACIEJEWSKI SECRETARY 1.00 1.00 X X 0 0 0 JUANITA BOCANEGRA TRUSTEE 1.00 1.00 X 0 0 0 MICHAEL HILL TRUSTEE 1.00 1.00 X 0 0 0 BILL VANDER VLIET MD TRUSTEE 1.00 1.00 X 0 0 0 GWEN AUWERDA TRUSTEE 1.00 1.00 X 0 0 0 LESLIE BROWN TRUSTEE 1.00 1.00 X 0 0 0 KEN FILIPPINI TRUSTEE 1.00 1.00 X 0 0 0 GREG CHRISTIE TRUSTEE 1.00 1.00 X 0 0 0 DOUG HOEY TRUSTEE 1.00 1.00 X 0 0 0 BARBARA DEPREE MD TRUSTEE 1.00 1.00 X 0 169716 17310 HAANS MULDER TRUSTEE 1.00 1.00 X 0 0 0 STEPHEN MAUGER TRUSTEE - PART YEAR 1.00 40.00 X 0 554481 26714 ALEX ROEHLING VP, FINANCE & CFO 1.00 40.00 X 0 301623 7769 MARK L PAWLAK SVP, QUALITY, IS & HOSP OP 1.00 40.00 X 0 580861 17327 PATTI VANDORT SVP, CNO, REHAB SERV, MARK 1.00 40.00 X 0 555272 15838 JOSEPH D BONELLO VICE PRESIDENT, NURSING-CNO 1.00 40.00 X 0 269814 24737 0 3218183 132175 0 0 1 0 SPECTRUM HEALTH MEDICAL GROUP 648 MONROE NW SUITE 300 GRAND RAPIDS MI 49503 MANAGEMENT SERVICES 117743 1 740782 299366 1040148 PATIENT FEES 621400 1355928 1355928 PHYSICIAN INCENTIVES 621400 268917 268917 1624845 2664993 1624845 0 0 X 2053034 2011577 41457 54185 54185 328401 328401 5499 5499 8212 8212 MEDICAL SUPPLIES AND DR 164003 164003 BAD DEBT EXPENSE 51659 51659 2664993 2569351 95642 0 558216 68967 88854 185629 55864 19927 8085 35937 655155 290533 619638 90802 35517 0 199731 655155 290533 X 0 0 0 0 655155 290533 0 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 55864 19927 35937 35937 RELATED PARTY PAYABLE 199731 199731 0 0 0 0 0 0 0 0 0 DALE M SOWDERS PRESIDENT-CEO 0 766445 0 0 0 19971 0 9150 0 13330 0 808896 0 0 MARK L PAWLAK SVP, QUALITY, IS & HOSP OP 0 422611 0 45090 0 113160 0 9130 0 8197 0 598188 0 0 STEPHEN MAUGER TRUSTEE - PART YEAR 0 285002 0 192670 0 76809 0 9150 0 17564 0 581195 0 0 PATTI VANDORT SVP, CNO, REHAB SERV, MARK 0 444822 0 91679 0 18771 0 9130 0 6708 0 571110 0 0 ALEX ROEHLING VP, FINANCE & CFO 0 242895 0 50797 0 7931 0 7417 0 352 0 309392 0 0 JOSEPH D BONELLO VICE PRESIDENT, NURSING-CNO 0 236713 0 28110 0 4991 0 7101 0 17636 0 294551 0 0 BARBARA DEPREE MD TRUSTEE 0 123271 0 25300 0 21145 0 4158 0 13152 0 187026 0 0 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. 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 HOLLAND COMMUNITY HOSPITAL 1 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 HOLLAND COMMUNITY HOSPITAL C 740782 PAYMENT RECEIVED AND DUE