MYMICHIGAN HOME CARE: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MYMICHIGAN HOME CARE (EIN 38-1459397)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202301319349306000
- Schema version
- 2021v4.2
- 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 | 2023-05-11T14:51:24-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381459397 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MYMICHIGAN HOME CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MYMI | BusinessNameControlTxt |
| Phone | 9898379039 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3007 N SAGINAW RD | AddressLine1Txt |
| City | MIDLAND | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 486404555 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUDI GRAVES | PersonNm |
| Person Title | CORPORATE CONTROLLER | PersonTitleTxt |
| Phone | 9898393181 | PhoneNum |
| Signature | 2023-05-11 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JUDI | PersonFirstNm |
| Person Last | GRAVES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DANA GARAFALO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3007 N SAGINAW RD | AddressLine1Txt |
| City | MIDLAND | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 486404555 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,670,759 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYMICHIGAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1941 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | CREATING HEALTHY COMMUNITIES TOGETHER BY PROVIDING EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 222 | TotalEmployeeCnt |
| Total Volunteers | 54 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,040,134 | PYContributionsGrantsAmt |
| CY Contributions Grants | $544,190 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,249,855 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,903,740 | CYProgramServiceRevenueAmt |
| PY Investment Income | $226,304 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,155,529 | CYInvestmentIncomeAmt |
| PY Other Revenue | $843,735 | PYOtherRevenueAmt |
| CY Other Revenue | $33,231 | CYOtherRevenueAmt |
| PY Total Revenue | $25,360,028 | PYTotalRevenueAmt |
| CY Total Revenue | $23,636,690 | 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 | $12,656,332 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,263,488 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,682,945 | PYOtherExpensesAmt |
| CY Other Expenses | $12,067,765 | CYOtherExpensesAmt |
| PY Total Expenses | $24,339,277 | PYTotalExpensesAmt |
| CY Total Expenses | $24,331,253 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,020,751 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$694,563 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,975,956 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,586,086 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,769,820 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,930,042 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,206,136 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,656,044 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CREATING HEALTHY COMMUNITIES - TOGETHER | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,058,742 | ExpenseAmt |
| Revenue | $6,439,786 | RevenueAmt |
| Desc | HOME HEALTH SERVICES - TO ENABLE PATIENTS TO BE AT HOME WHILE RECUPERATING AND RECEIVING QUALITY MEDICAL CARE. THIS INCLUDES NURSING SERVICES, SPEECH, PHYSICAL, AND OCCUPATIONAL THERAPIES, AND SOCIAL WORK. PATIENTS ARE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY. TOTAL VISITS = 47,463. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,232,140 | ExpenseAmt |
| Revenue | $5,783,175 | RevenueAmt |
| Desc | HOSPICE - PROVIDES PALLIATIVE CARE AND SUPPORTIVE SERVICES (PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL CARE) FOR DYING PATIENTS AND THEIR FAMILIES. PATIENTS ARE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY. TOTAL VISITS = 19,266. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,596,915 | ExpenseAmt |
| Revenue | $8,424,501 | RevenueAmt |
| Desc | HOME INFUSION - OFFERS PATIENTS THE OPTION OF RECEIVING INTRAVENOUS MEDICATION IN THE COMFORT OF THEIR OWN HOMES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $768,327 | ExpenseAmt |
| Revenue | $289,509 | RevenueAmt |
| Desc | HOME MEDICAL EQUIPMENT- 11,855AFFILIATED RELATED INCOME- 242,145CONTRACTED CLINICAL SERVICES-2,278OTHER REVENUE-33,231 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $768,327 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $289,509 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $20,656,124 | 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 | Yes (1) | 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 | 222 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUDI GRAVES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9898379039 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4000 WELLNESS DR | AddressLine1Txt |
| City | MIDLAND | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| ROGERS GREGORY | |||||||||
| DIRECTOR (PART YEAR) | 2.00 | 50.00 | Yes (X) | $0 | $1,103,048 | $546,181 | |||
| ROSE MICHAEL | |||||||||
| SECRETARY/TREASURER | 2.00 | 50.00 | $0 | $678,863 | $129,969 | Yes (X) | |||
| PADGETT FRANCINE | |||||||||
| FORMER SECRETARY/TREASURER | 0.00 | 0.00 | $0 | $676,976 | $0 | Yes (X) | |||
| JANDWANI MD PANKAJ | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $570,850 | $16,370 | |||
| BERG MD PAUL | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $488,270 | $87,048 | |||
| CROSS BRYAN | |||||||||
| CHAIR (PART YEAR) | 2.00 | 50.00 | Yes (X) | $0 | $485,699 | $80,672 | Yes (X) | ||
| GREELEY MARY | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $370,206 | $122,277 | |||
| POKORZYNSKI DEB | |||||||||
| DIRECTOR (PART YEAR) | 2.00 | 50.00 | Yes (X) | $0 | $192,942 | $277,147 | |||
| TERRELL TAMMY | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $337,801 | $30,984 | |||
| KING GLENN | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $228,091 | $36,092 | |||
| GILLETTE NICOLE | |||||||||
| DIRECTOR (PART YEAR) | 2.00 | 50.00 | Yes (X) | $0 | $216,325 | $31,287 | |||
| CHADWICK LEEANN | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $193,345 | $28,246 | |||
| AULTMAN RACHEL | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $187,323 | $28,796 | |||
| DULL ANN | |||||||||
| DIRECTOR | 2.00 | 50.00 | Yes (X) | $0 | $177,685 | $37,443 | |||
| GARAFALO DANA | |||||||||
| INTERIM PRESIDENT/VICE CHAIR | 50.00 | 0.00 | Yes (X) | $188,774 | $0 | $11,150 | Yes (X) | ||
| GISSE MARY | |||||||||
| PHARMACIST | 50.00 | 0.00 | $139,719 | $0 | $22,443 | Yes (X) | |||
| PARKS AMBER | |||||||||
| RN | 50.00 | 0.00 | $120,088 | $0 | $8,396 | Yes (X) | |||
| KELLOGG AMANDA | |||||||||
| NP | 50.00 | 0.00 | $115,692 | $0 | $6,781 | Yes (X) | |||
| SMALLEY MARLENE | |||||||||
| MANAGER RN | 50.00 | 0.00 | $106,752 | $0 | $10,109 | Yes (X) | |||
| HALE REBECKA | |||||||||
| MANAGER OF HOME CARE | 50.00 | 0.00 | $105,089 | $0 | $6,347 | Yes (X) | |||
| RAPP DONNA | |||||||||
| FORMER SECRETARY | 0.00 | 0.00 | $0 | $100,549 | $0 | Yes (X) | |||
| BROWN LANELLE | |||||||||
| DIRECTOR (PART YEAR) | 2.00 | 50.00 | Yes (X) | $0 | $96,666 | $21,543 | |||
| KANE THOMAS | |||||||||
| DIRECTOR (PART YEAR) | 2.00 | 50.00 | Yes (X) | $0 | $9,150 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $776,114 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,113,789 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,539,281 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $544,190 | GovernmentGrantsAmt |
| Total Contributions | $544,190 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621610 | $13,870,354 | $13,870,354 |
| MEDICARE/MEDICAID | 621610 | $6,788,963 | $6,788,963 |
| AFFILIATE RELATED INCOME | 900099 | $242,145 | $242,145 |
| CONTRACTED CLINICAL SERVICES | 621610 | $2,278 | $2,278 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,903,740 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $260,319 | TotalRevenueColumnAmt |
| Exclusion | $260,319 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,929,279 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,034,069 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,895,210 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,895,210 | TotalRevenueColumnAmt |
| Exclusion | $1,895,210 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $33,231 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,231 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $33,231 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,636,690 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,936,971 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,155,529 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,424 | TotalAmt |
| Management And General | $197,424 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,549,937 | TotalAmt |
| Program Services | $9,699,974 | ProgramServicesAmt |
| Management And General | $849,963 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,125 | TotalAmt |
| Program Services | $177,847 | ProgramServicesAmt |
| Management And General | $279,278 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,053 | TotalAmt |
| Program Services | $248,556 | ProgramServicesAmt |
| Management And General | $26,497 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $783,949 | TotalAmt |
| Program Services | $720,326 | ProgramServicesAmt |
| Management And General | $63,623 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $631 | TotalAmt |
| Program Services | $631 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,615 | TotalAmt |
| Management And General | $2,615 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,292 | TotalAmt |
| Program Services | $158,207 | ProgramServicesAmt |
| Management And General | $43,085 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,915 | TotalAmt |
| Program Services | $462 | ProgramServicesAmt |
| Management And General | $2,453 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,714 | TotalAmt |
| Program Services | $126,537 | ProgramServicesAmt |
| Management And General | $32,177 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,211 | TotalAmt |
| Program Services | $38,907 | ProgramServicesAmt |
| Management And General | $12,304 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $643,306 | TotalAmt |
| Program Services | $636,899 | ProgramServicesAmt |
| Management And General | $6,407 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,119 | TotalAmt |
| Program Services | $6,721 | ProgramServicesAmt |
| Management And General | $1,398 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,375 | TotalAmt |
| Program Services | $30,693 | ProgramServicesAmt |
| Management And General | $57,682 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,926 | TotalAmt |
| Management And General | $117,926 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COST OF GOODS SOLD | $7,434,701 | $7,434,701 | |
| SUBSIDIARY EXPENSES | $1,933,021 | $1,933,021 | |
| CONTRACT SERVICES | $1,032,273 | $982,997 | $49,276 |
| PATIENT CARE EXPENSE | $392,666 | $392,666 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,331,253 | TotalAmt |
| Program Services | $20,656,124 | ProgramServicesAmt |
| Management And General | $3,675,129 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99 | BOYAmt |
| EOY | $100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,343,382 | BOYAmt |
| EOY | $1,616,491 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,269,585 | BOYAmt |
| EOY | $2,702,987 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,528 | BOYAmt |
| EOY | $141,455 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,263,516 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $328,742 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $904,446 | BOYAmt |
| EOY | $934,774 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,646,111 | BOYAmt |
| EOY | $3,285,555 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,564,805 | BOYAmt |
| EOY | $2,904,724 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,975,956 | BOYAmt |
| EOY | $11,586,086 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $940,189 | BOYAmt |
| EOY | $1,127,109 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,263,982 | BOYAmt |
| EOY | $356,477 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $565,649 | BOYAmt |
| EOY | $446,456 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,769,820 | BOYAmt |
| EOY | $1,930,042 | 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 | $13,206,136 | BOYAmt |
| EOY | $9,656,044 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,206,136 | BOYAmt |
| EOY | $9,656,044 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,975,956 | BOYAmt |
| EOY | $11,586,086 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$694,563 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,855,529 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,040,134 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $544,190 | CurrentTaxYearAmt |
| Total | $1,584,324 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,214,860 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,631,875 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,353,727 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,013,698 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,661,595 | CurrentTaxYearAmt |
| Total | $113,875,755 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,214,860 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,631,875 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,353,727 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,053,832 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,205,785 | CurrentTaxYearAmt |
| Total | $115,460,079 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,545,872 | CurrentTaxYearAmt |
| Total | $2,545,872 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $2,545,872 | CurrentTaxYearAmt |
| Total | $2,545,872 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $112,914,207 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81,052 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $99,820 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $156,762 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $158,538 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $260,319 | CurrentTaxYearAmt |
| Total | $756,491 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81,052 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $99,820 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $156,762 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $158,538 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $260,319 | CurrentTaxYearAmt |
| Total | $756,491 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $255,543 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $173,085 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $226,924 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $236,157 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $275,375 | CurrentTaxYearAmt |
| Total | $1,167,084 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,551,455 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,904,780 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,737,413 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,448,527 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,741,479 | CurrentTaxYearAmt |
| Total | $117,383,654 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.96190 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98490 | PublicSupportPY509Pct |
| Investment Income CY | 0.00640 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00520 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | FUNDS RELEASED FROM RESTRICTION FOR CHARITY CARE - 2017 AMOUNT: $ 255,543. 2018 AMOUNT: $ 173,085. 2019 AMOUNT: $ 226,924. 2020 AMOUNT: $ 236,157. 2021 AMOUNT: $ 242,145. OTHER REVENUE - 2021 AMOUNT: $ 33,230. | ExplanationTxt |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $160,000 | OtherCostOrOtherBasisAmt |
| Book Value | $160,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $693,400 | OtherCostOrOtherBasisAmt |
| Depreciation | $210,350 | DepreciationAmt |
| Book Value | $483,050 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,806 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,886 | DepreciationAmt |
| Book Value | $8,920 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $380,760 | OtherCostOrOtherBasisAmt |
| Depreciation | $115,506 | DepreciationAmt |
| Book Value | $265,254 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,550 | OtherCostOrOtherBasisAmt |
| Book Value | $17,550 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $934,774 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (5 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| HEDGE FUNDS | $326,779 | F |
| BLACKROCK DOMESTIC EQUITY | $1,099,612 | F |
| BLACKROCK INTL EQUITY | $747,610 | F |
| BLACKROCK FIXED INCOME | $368,950 | F |
| CLARION & CORNERSTONE | $361,773 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,904,724 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SELF-INSURANCE, DEFERRED COMP, OTHER | Desc |
| Amt | $446,456 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $446,456 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROGERS GREGORY | ||||||||||||||
| DIRECTOR (PART YEAR) | $0 | $613,085 | $0 | $273,178 | $0 | $216,785 | $0 | $527,107 | $0 | $19,074 | $0 | $1,649,229 | $0 | $185,189 |
| ROSE MICHAEL | ||||||||||||||
| SECRETARY/TREASURER | $0 | $513,812 | $0 | $162,500 | $0 | $2,551 | $0 | $99,470 | $0 | $30,499 | $0 | $808,832 | $0 | $0 |
| PADGETT FRANCINE | ||||||||||||||
| FORMER SECRETARY/TREASURER | $0 | $0 | $0 | $0 | $0 | $676,976 | $0 | $0 | $0 | $0 | $0 | $676,976 | $0 | $78,227 |
| JANDWANI MD PANKAJ | ||||||||||||||
| DIRECTOR | $0 | $438,587 | $0 | $130,822 | $0 | $1,441 | $0 | $14,500 | $0 | $1,870 | $0 | $587,220 | $0 | $0 |
| BERG MD PAUL | ||||||||||||||
| DIRECTOR | $0 | $376,523 | $0 | $110,978 | $0 | $769 | $0 | $56,327 | $0 | $30,721 | $0 | $575,318 | $0 | $0 |
| CROSS BRYAN | ||||||||||||||
| CHAIR (PART YEAR) | $0 | $343,122 | $0 | $131,251 | $0 | $11,326 | $0 | $60,941 | $0 | $19,731 | $0 | $566,371 | $0 | $0 |
| GREELEY MARY | ||||||||||||||
| DIRECTOR | $0 | $266,806 | $0 | $100,948 | $0 | $2,452 | $0 | $95,501 | $0 | $26,776 | $0 | $492,483 | $0 | $0 |
| POKORZYNSKI DEB | ||||||||||||||
| DIRECTOR (PART YEAR) | $0 | $149,929 | $0 | $35,011 | $0 | $8,002 | $0 | $254,614 | $0 | $22,533 | $0 | $470,089 | $0 | $0 |
| TERRELL TAMMY | ||||||||||||||
| DIRECTOR | $0 | $258,257 | $0 | $76,028 | $0 | $3,516 | $0 | $17,400 | $0 | $13,584 | $0 | $368,785 | $0 | $0 |
| KING GLENN | ||||||||||||||
| DIRECTOR | $0 | $176,975 | $0 | $41,549 | $0 | $9,567 | $0 | $11,724 | $0 | $24,368 | $0 | $264,183 | $0 | $0 |
| GILLETTE NICOLE | ||||||||||||||
| DIRECTOR (PART YEAR) | $0 | $174,990 | $0 | $40,501 | $0 | $834 | $0 | $11,088 | $0 | $20,199 | $0 | $247,612 | $0 | $0 |
| CHADWICK LEEANN | ||||||||||||||
| DIRECTOR | $0 | $152,949 | $0 | $35,180 | $0 | $5,216 | $0 | $9,860 | $0 | $18,386 | $0 | $221,591 | $0 | $0 |
| AULTMAN RACHEL | ||||||||||||||
| DIRECTOR | $0 | $151,968 | $0 | $35,049 | $0 | $306 | $0 | $11,514 | $0 | $17,282 | $0 | $216,119 | $0 | $0 |
| DULL ANN | ||||||||||||||
| DIRECTOR | $0 | $139,508 | $0 | $32,063 | $0 | $6,114 | $0 | $18,924 | $0 | $18,519 | $0 | $215,128 | $0 | $0 |
| GARAFALO DANA | ||||||||||||||
| INTERIM PRESIDENT/VICE CHAIR | $153,655 | $0 | $34,431 | $0 | $688 | $0 | $9,426 | $0 | $1,724 | $0 | $199,924 | $0 | $0 | $0 |
| GISSE MARY | ||||||||||||||
| PHARMACIST | $136,510 | $0 | $2,125 | $0 | $1,084 | $0 | $7,245 | $0 | $15,198 | $0 | $162,162 | $0 | $0 | $0 |
| RAPP DONNA | ||||||||||||||
| FORMER SECRETARY | $0 | $0 | $0 | $0 | $0 | $100,549 | $0 | $0 | $0 | $0 | $0 | $100,549 | $0 | $100,549 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | ROGERS, ROSE, BERG, AND GREELEY ARE PARTICIPANTS IN A 457(F) PLAN. ROGERS RECEIVED A PAYMENT IN 2021. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THE MEMBERS OF THE SENIOR LEADERSHIP OR EXECUTIVE TEAM. EACH PARTICIPANT'S ANNUAL AWARD IS BASED ON THEIR POSITION LEVEL AND IS A PERCENTAGE OF BASE SALARY ON DECEMBER 31 OF THE PLAN YEAR. THE PLAN PROVIDES ADDITIONAL RETIREMENT INCOME WHICH OTHERWISE WOULD BE PROVIDED UNDER THE PENSION PLAN AND 403(B) PLAN, BUT FOR LIMITATIONS ON SUCH BENEFITS REQUIRED BY FEDERAL LAW. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MYMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, ON THE THREE-YEAR ANNIVERSARY OF THEIR PARTICIPATION DATE. |
| PART I, LINE 7 | MYMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE INDEPENDENT COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE COMPENSATION COMMITTEE, WHO IS AUTHORIZED TO ACT ON BEHALF OF THE MYMICHIGAN HEALTH BOARD OF DIRECTORS, APPROVED COMPESNATION FOR THE MYMICHIGAN HEALTH CEO, SENIOR EXECUTIVES AND PHYSICIANS. SULLIVAN COTTER ANNUALLY CONDUCTS A COMPREHENSIVE ASSESSMENT OF EXECUTIVE COMPENSATION. |
| PART III: | MYMICHIGAN HEALTH'S COMPENSATION COMMITTEE CHARTER IS APPROVED ANNUALLY BY THE COMMITTEE AND BOARD AS WERE THE EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. MYMICHIGAN HEALTH ALSO CONTINUES TO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MYMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MYMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED NATIONALLY FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MYMICHIGAN HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF MYMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF ANY AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GAURANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; AND G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE STAFF AT EACH SUBSIDIARY UPLOADS INFORMATION INTO THE SOFTWARE WHICH IS THEN REVIEWED BY THE CORPORATE CONTROLLER AT MYMICHIGAN HEALTH, THE SOLE MEMBER OF THIS CORPORATION. THE CORPORATE CONTROLLER REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. A FINAL REVIEW IS THEN DONE BY THE SVP AND CFO. IN ADDITION, ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MYMICHIGAN HEALTH CEO PRIOR TO FILING. THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE PRIOR TO FILING. FORM 990, INCLUDING ALL SCHEDULES, IS NOT MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS BECAUSE THE BOARD IS COMPRISED OF INTERNAL EMPLOYEES OF MYMICHIGAN HEALTH, THE SOLE MEMBER, THEREFORE THESE RETURNS ARE REVIEWED BY THE MYMICHIGAN HEALTH CEO AND CFO PRIOR TO FILING. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MYMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES MAY BE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND AT A MINIMUM ARE REQUIRED TO ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT INDEPENDENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO, PRESIDENTS, AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MYMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). ALL OFFICERS AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| PART VII, SECTION B, LINE 1 | INDEPENDENT CONTRACTORS FOR ALL RELATED ORGANIZATIONS ARE COMPENSATED BY MYMICHIGAN HEALTH, 38-2459948, THE SOLE MEMBER OF THIS ORGANIZATION. |
| FORM 990, PART VII, LINE 4: | NO DIRECTORS RECEIVED PAY FOR THE PURPOSE OF SERVING ON THE BOARD, BUT MAY BE COMPENSATED FOR OTHER SERVICES PROVIDED TO THE ORGANIZATION. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MYMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MYMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES ARE NOT TRACKED BY SUBSIDIARY. THEREFORE THE FULL-TIME SERVICE TO ALL SUBSIDIARIES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| MYMICHIGAN HEALTH | ||||||||||
| 4000 WELLNESS DR | MIDLAND | MI | 48670 | 382459948 | SUPPORT | MI | 501(C)(3) | LINE 12A, I | 0 | |
| MYMICHIGAN MEDICAL CENTER MIDLAND | ||||||||||
| 4000 WELLNESS DR | MIDLAND | MI | 48670 | 380833014 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL CENTER ALMA | ||||||||||
| 300 E WARWICK DR | ALMA | MI | 48801 | 381437919 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL CENTER CLARE | ||||||||||
| 703 N MCEWAN ST | CLARE | MI | 48617 | 381518643 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL CENTER GLADWIN | ||||||||||
| 515 QUARTER ST | GLADWIN | MI | 48624 | 386020434 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL CENTER ALPENA | ||||||||||
| 1501 W CHISHOLM ST | ALPENA | MI | 49707 | 386000029 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL GROUP | ||||||||||
| 2620 W SUGNET RD | MIDLAND | MI | 48640 | 383317788 | MEDICAL OFFICE | MI | 501(C)(3) | LINE 12A, I | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN HEALTH DEVELOPMENT ASSOCIATES | ||||||||||
| 4000 WELLNESS DR | MIDLAND | MI | 48670 | 382459947 | OPERATIONS | MI | 501(C)(2) | 0 | MYMICHIGAN HEALTH | |
| MYMICHIGAN HEALTH FOUNDATION | ||||||||||
| 4000 WELLNESS DR | MIDLAND | MI | 48670 | 812813405 | FOUNDATION | MI | 501(C)(3) | LINE 12A, I | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL CENTER WEST BRANCH | ||||||||||
| 2463 S M-30 | WEST BRANCH | MI | 48661 | 464088182 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
| MYMICHIGAN MEDICAL CENTER SAULT | ||||||||||
| 500 OSBORN BOULEVARD | SAULT STE MARIE | MI | 49783 | 382602147 | HOSPITAL | MI | 501(C)(3) | LINE 3 | 0 | MYMICHIGAN HEALTH |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| MYMICHIGAN HEALTH PAIN MANAGEMENT | |||||||||
| 2463 SOUTH M-30 | WEST BRANCH | MI | 48661 | 834186622 | HEALTHCARE PAIN MANAGEMENT | MI | N/A | 0 | 0 |
| ISOMM | |||||||||
| 211 S CRAPO ST STE H | MT PLEASANT | MI | 48858 | 270867311 | MRI SERVICES | MI | N/A | 0 | 0 |
| 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 | 0 | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments