THUNDER BAY COMMUNITY HEALTH SERVICE INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- THUNDER BAY COMMUNITY HEALTH SERVICE INC (EIN 38-2290337)
- Tax period
- 2022-03-01 to 2023-02-28
- Filed
- 2023-10-02
- IRS object ID
- 202312759349301611
- 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 | 2023-10-02T12:42:09-04:00 | ReturnTs |
| Tax Period End | 2023-02-28 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382963463 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUAST JANKE & CO CPA'S PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1010 N JOHNSON | AddressLine1Txt |
| City | BAY CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48708 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382290337 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THUNDER BAY COMMUNITY HEALTH SERVIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | THUN | BusinessNameControlTxt |
| Phone | 9897424583 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15774 STATE ST PO BOX 427 | AddressLine1Txt |
| City | HILLMAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49746 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD BATES | PersonNm |
| Person Title | INTERIM CEO | PersonTitleTxt |
| Phone | 9893542197 | PhoneNum |
| Signature | 2023-09-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RICHARD | PersonFirstNm |
| Person Last | BATES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 888008888 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT E FRISKE CPA | PreparerPersonNm |
| PTIN | P01083831 | PTIN |
| Phone | 9898924549 | PhoneNum |
| Preparation | 2023-09-14 | PreparationDt |
| 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 | RICHARD BATES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8561 US 23 SOUTH | AddressLine1Txt |
| City | OSSINEKE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49766 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,436,724 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TBCHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS ITS RESOURCES TO BUILDING HEALTHIER COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 280 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $10,268,542 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,467,801 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,939,468 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,816,297 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,281 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,174 | CYInvestmentIncomeAmt |
| PY Other Revenue | $90,146 | PYOtherRevenueAmt |
| CY Other Revenue | $146,452 | CYOtherRevenueAmt |
| PY Total Revenue | $28,303,437 | PYTotalRevenueAmt |
| CY Total Revenue | $27,436,724 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,772,403 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,082,288 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,993,800 | PYOtherExpensesAmt |
| CY Other Expenses | $9,916,409 | CYOtherExpensesAmt |
| PY Total Expenses | $24,766,203 | PYTotalExpensesAmt |
| CY Total Expenses | $25,998,697 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,537,234 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,438,027 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,795,409 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,539,135 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,946,328 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,401,301 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,849,081 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,137,834 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS ITS RESOURCES TO BUILDING HEALTHIER COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $20,031,093 | ExpenseAmt |
| Revenue | $20,816,297 | RevenueAmt |
| Desc | THIS FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER HAD 18,384 PATIENTS AND PROVIDED 76,243 CLINICAL VISITS INCLUDING MEDICAL, DENTAL,OPTOMETRY AND BEHAVIORAL HEALTH SERVICES. | Desc |
| Total Program Service Expenses | $20,031,093 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 280 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEIGHANN VIERS | PersonNm |
| Phone | 9893542197 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N RIPLEY SUITE E | AddressLine1Txt |
| City | ALPENA | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49707 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| MARION HAUTEA | ||||||||
| CMO | 40.00 | Yes (X) | $319,961 | $0 | $46,435 | |||
| JEMELLEE JACALA-TADIAN | ||||||||
| PHYSICIAN | 40.00 | $297,000 | $0 | $45,653 | Yes (X) | |||
| MANUEL HERNANDEZ | ||||||||
| PHYSICIAN | 40.00 | $274,529 | $0 | $60,201 | Yes (X) | |||
| OSAMA AHMED | ||||||||
| PHYSICIAN | 40.00 | $265,510 | $0 | $32,930 | Yes (X) | |||
| MUHAMMAD ABDELHAI | ||||||||
| PHSICIAN | 40.00 | $264,809 | $0 | $27,764 | Yes (X) | |||
| MICHELLE STYMA | ||||||||
| CEO | 40.00 | $253,174 | $0 | $38,759 | Yes (X) | |||
| JEFFREY TAYLOR | ||||||||
| DENTIST | 40.00 | $231,947 | $0 | $31,139 | Yes (X) | |||
| LEIGHANN VIERS | ||||||||
| CFO | 40.00 | Yes (X) | $127,967 | $0 | $27,697 | |||
| KAYLA BERRY | ||||||||
| COO | 40.00 | Yes (X) | $105,159 | $0 | $24,414 | |||
| RICHARD BATES | ||||||||
| INTERIM CEO | 40.00 | Yes (X) | $37,500 | $0 | $1,365 | |||
| BEN BOLSER | ||||||||
| CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| BRENDAN CONBOY | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| MICHAEL FAIRBANKS | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| BEACH HALL | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| SHANNA JOHNSON | ||||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| JULIE KENDRICK | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| NINA KENNARD | ||||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| CARRIE LOHMAN | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| AL MOE | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| SUSAN STACEY | ||||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| MARVIN TAYLOR | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| TOMMIE WOLFF | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| MIKE WURTSMITH | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,177,556 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $336,357 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 29 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JOHN ALEXANDER | |||||
| 4530 MARSH WOOD CT SE | SOUTHPORT | NC | 28461 | PROF SERVICES | $151,847 |
| BRUCE DIETZ | |||||
| 430 S STATE AVE | ALPENA | MI | 49707 | RENT | $137,640 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,458,806 | GovernmentGrantsAmt |
| All Other Contributions | $8,995 | AllOtherContributionsAmt |
| Total Contributions | $6,467,801 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT FEES | $11,531,057 | $11,531,057 |
| PHARMACY SALES | $8,882,464 | $8,882,464 |
| INCENTIVES | $139,067 | $139,067 |
| SCHOOL NURSE | $97,935 | $97,935 |
| OTHER PROGRAM REVENUE | $78,858 | $78,858 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,916 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,916 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,816,297 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,174 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,174 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MI COMM HEALTH NETWORK | Desc |
| Total Revenue Column | $146,452 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $146,452 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $146,452 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,436,724 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,968,923 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $590,587 | TotalAmt |
| Program Services | $319,961 | ProgramServicesAmt |
| Management And General | $270,626 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,174 | TotalAmt |
| Management And General | $253,174 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,453,206 | TotalAmt |
| Program Services | $8,533,965 | ProgramServicesAmt |
| Management And General | $2,919,241 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,873,729 | TotalAmt |
| Program Services | $1,941,575 | ProgramServicesAmt |
| Management And General | $932,154 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $911,592 | TotalAmt |
| Program Services | $648,918 | ProgramServicesAmt |
| Management And General | $262,674 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,418,131 | TotalAmt |
| Program Services | $1,945,809 | ProgramServicesAmt |
| Management And General | $472,322 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,739 | TotalAmt |
| Program Services | $130,780 | ProgramServicesAmt |
| Management And General | $22,959 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,318 | TotalAmt |
| Program Services | $203,706 | ProgramServicesAmt |
| Management And General | $134,612 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $455,252 | TotalAmt |
| Program Services | $262,585 | ProgramServicesAmt |
| Management And General | $192,667 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,644 | TotalAmt |
| Program Services | $138,243 | ProgramServicesAmt |
| Management And General | $95,401 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,079 | TotalAmt |
| Program Services | $95,519 | ProgramServicesAmt |
| Management And General | $19,560 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $813,082 | TotalAmt |
| Program Services | $678,281 | ProgramServicesAmt |
| Management And General | $134,801 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,489 | TotalAmt |
| Program Services | $23,837 | ProgramServicesAmt |
| Management And General | $24,652 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,669,561 | $4,669,561 | |
| REPAIR AND MAINT | $388,032 | $359,825 | $28,207 |
| DUES AND LICENSES | $190,472 | $62,101 | $128,371 |
| OTHER | $92,610 | $16,427 | $76,183 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,998,697 | TotalAmt |
| Program Services | $20,031,093 | ProgramServicesAmt |
| Management And General | $5,967,604 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,035 | BOYAmt |
| EOY | $415,458 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,335,647 | BOYAmt |
| EOY | $5,228,528 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $340,547 | BOYAmt |
| EOY | $394,918 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,781,440 | BOYAmt |
| EOY | $1,961,081 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,984 | BOYAmt |
| EOY | $194,759 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,161 | BOYAmt |
| EOY | $305,416 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,442,085 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,778,299 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,224,232 | BOYAmt |
| EOY | $10,663,786 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,000 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,000 | BOYAmt |
| EOY | $14,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $175,556 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,363 | BOYAmt |
| EOY | $180,633 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,795,409 | BOYAmt |
| EOY | $19,539,135 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,198,625 | BOYAmt |
| EOY | $1,299,276 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,939 | BOYAmt |
| EOY | $360,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,563,764 | BOYAmt |
| EOY | $3,580,610 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $161,415 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,946,328 | BOYAmt |
| EOY | $5,401,301 | 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 | $12,849,081 | BOYAmt |
| EOY | $14,137,834 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,849,081 | BOYAmt |
| EOY | $14,137,834 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,795,409 | BOYAmt |
| EOY | $19,539,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,438,027 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$2,822 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$146,452 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $445,021 | OtherCostOrOtherBasisAmt |
| Book Value | $445,021 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,856,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,395,259 | DepreciationAmt |
| Book Value | $8,461,041 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $966,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $150,448 | DepreciationAmt |
| Book Value | $816,443 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,173,873 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,232,592 | DepreciationAmt |
| Book Value | $941,281 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,663,786 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ROU - FINANCE LEASES | $85,662 |
| ROU - OPERATING LEASE | $75,753 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $161,415 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $27,389,872 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $99,600 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $99,600 | RevenueNotReportedAmt |
| Revenue Subtotal | $27,290,272 | RevenueSubtotalAmt |
| Other Revenues Not Included | $146,452 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $146,452 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $27,436,724 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,098,297 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $99,600 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $99,600 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,998,697 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $25,998,697 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XI, LINE 4B | FormAndLineReferenceDesc |
| Explanation | MI COMMUNITY HEALTH NETWORK K-1 146,452 | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| MARION HAUTEA | ||||
| CMO | $319,961 | $37,112 | $9,323 | $366,396 |
| JEMELLEE JACALA-TADIAN | ||||
| PHYSICIAN | $297,000 | $36,386 | $9,267 | $342,653 |
| MANUEL HERNANDEZ | ||||
| PHYSICIAN | $274,529 | $30,499 | $29,702 | $334,730 |
| OSAMA AHMED | ||||
| PHYSICIAN | $265,510 | $29,845 | $3,085 | $298,440 |
| MUHAMMAD ABDELHAI | ||||
| PHSICIAN | $264,809 | $23,387 | $4,377 | $292,573 |
| MICHELLE STYMA | ||||
| CEO | $253,174 | $34,481 | $4,278 | $291,933 |
| JEFFREY TAYLOR | ||||
| DENTIST | $231,947 | $27,831 | $3,308 | $263,086 |
| LEIGHANN VIERS | ||||
| CFO | $127,967 | $25,584 | $2,113 | $155,664 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | BOARD MEMBERS ARE ALL VOLUNTEERS IN ADDITION TO COMMUNITY MEMBERS WHO DONATE TIME FOR VARIOUS CENTER ACTIVITIES |
| FORM 990, PAGE 6, PART VI, LINE 11B | AUDITOR REVIEWS RETURN WITH FINANCE COMMITTEE AND PRESENTS REVIEW TO ENTIRE BOARD PRIOR TO SUBMISSION |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS SUBMIT WRITTEN STATEMENTS TO EXECUTIVE TEAM FOR REVIEW ON ANY CONFLICT OF INTEREST ISSUES |
| FORM 990, PAGE 6, PART VI, LINE 15A | CEO COMPENSATION IS DETERMINED BY EXECUTIVE COMMITTEE BASED UPON COMPARABILITY DATA FOR SIMILIAR POSTION. ENTIRE BOARD MAKES FINAL APPROVAL OF WAGE DETERMINATION |
| FORM 990, PAGE 6, PART VI, LINE 15B | BOARD APPROVES WAGES OF CEO AND KEY EMPLOYEES BASED UPON BOARD APPROVED WAGE SCALE |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST, PREFERABLY IN WRITING. THE ORGANIZATION MAKES COPIES OF THE REQUESTED DOCUMENTS AND MAKES THEM AVAILABLE FOR PICK UP OR MAIL TO THE REQUESTEE. |
| FORM 990, PART XI, LINE 9 | MI COMM HEALTH NETWORK -146,452 |