THUNDER BAY COMMUNITY HEALTH SERVICE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- THUNDER BAY COMMUNITY HEALTH SERVICE INC (EIN 38-2290337)
- Tax period
- 2021-03-01 to 2022-02-28
- Filed
- 2022-09-29
- IRS object ID
- 202212729349300831
- Schema version
- 2021v4.0
- 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 | 2022-09-29T11:59:34-04:00 | ReturnTs |
| Tax Period End | 2022-02-28 | 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 | 2021-03-01 | 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 | MICHELLE STYMA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9893542197 | PhoneNum |
| Signature | 2022-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHELLE | PersonFirstNm |
| Person Last | STYMA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT E FRISKE CPA | PreparerPersonNm |
| PTIN | P01083831 | PTIN |
| Phone | 9898924549 | PhoneNum |
| Preparation | 2022-09-26 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHELLE STYMA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8855 N M 65 | AddressLine1Txt |
| City | POSEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49776 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,303,437 | 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 | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 286 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,881,359 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,268,542 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,622,817 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,939,468 | CYProgramServiceRevenueAmt |
| PY Investment Income | $33,479 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,281 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$6,859 | PYOtherRevenueAmt |
| CY Other Revenue | $90,146 | CYOtherRevenueAmt |
| PY Total Revenue | $24,530,796 | PYTotalRevenueAmt |
| CY Total Revenue | $28,303,437 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,346,218 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,772,403 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,466,762 | PYOtherExpensesAmt |
| CY Other Expenses | $8,993,800 | CYOtherExpensesAmt |
| PY Total Expenses | $21,812,980 | PYTotalExpensesAmt |
| CY Total Expenses | $24,766,203 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,717,816 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,537,234 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,514,993 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,795,409 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,041,838 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,946,328 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,473,155 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,849,081 | 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 | $18,675,160 | ExpenseAmt |
| Revenue | $17,939,468 | RevenueAmt |
| Desc | THIS FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER HAD 17,704 PATIENTS AND PROVIDED 74,709 CLINICAL VISITS INCLUDING MEDICAL, DENTAL,OPTOMETRY AND BEHAVIORAL HEALTH SERVICES. | Desc |
| Total Program Service Expenses | $18,675,160 | 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 | false | 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 | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 286 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| MANUEL HERNANDEZ | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $264,333 | $0 | $52,006 | ||
| JEMELLEE JACALA-TADIAN | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $270,431 | $0 | $38,003 | ||
| MARION HAUTEA | |||||||
| CMO | 40.00 | $264,740 | $0 | $41,628 | Yes (X) | ||
| MICHELLE STYMA | |||||||
| CEO | 40.00 | $235,555 | $0 | $34,657 | Yes (X) | ||
| JEFFREY TAYLOR | |||||||
| DENTIST | 40.00 | Yes (X) | $233,767 | $0 | $32,791 | ||
| WAYNE MCEWEN | |||||||
| PHSICIAN ASS | 40.00 | Yes (X) | $183,060 | $0 | $32,323 | ||
| EMILY HILL | |||||||
| DENTIST | 40.00 | Yes (X) | $154,446 | $0 | $30,153 | ||
| LEIGHANN VIERS | |||||||
| CFO | 40.00 | $103,607 | $0 | $25,909 | Yes (X) | ||
| KAYLA BERRY | |||||||
| COO | 40.00 | $99,939 | $0 | $24,517 | Yes (X) | ||
| BEN BOLSER | |||||||
| CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MICHAEL FAIRBANKS | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| BEACH HALL | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| SHANNA JOHNSON | |||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JULIE KENDRICK | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| NINA KENNARD | |||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CARRIE LOHMAN | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| AL MOE | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| SUSAN STACEY | |||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| TOMMIE WOLFF | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MIKE WURTSMITH | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,809,878 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $311,987 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMERICIAL CONTRACTING NORTH | |||||
| 181 N INDUSTRIAL HWY | ALPENA | MI | 49707 | CONSTRUCTION | $593,394 |
| SOUTH ARM CONSTRUCTION | |||||
| PO BOX 1069 | EAST JORDAN | MI | 49727 | CONSTRUCTION | $283,550 |
| BRUCE DIETZ DEVELPER | |||||
| 100 N RIPLEY | ALPENA | MI | 49707 | CONSTRUCTION | $186,117 |
| BRUCE DIETZ | |||||
| 430 S STATE AVE | ALPENA | MI | 49707 | RENT | $134,553 |
| JOHN ALEXANDER | |||||
| 4530 MARSH WOOD CT SE | SOUTHPORT | NC | 28461 | PROF SERVICES | $105,158 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,263,633 | GovernmentGrantsAmt |
| All Other Contributions | $4,909 | AllOtherContributionsAmt |
| Total Contributions | $10,268,542 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT FEES | $9,642,773 | $9,642,773 |
| PHARMACY SALES | $7,574,229 | $7,574,229 |
| INCENTIVES | $410,029 | $410,029 |
| OTHER PROGRAM REVENUE | $154,445 | $154,445 |
| SCHOOL NURSE | $103,395 | $103,395 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,597 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,597 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,939,468 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,281 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,281 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MI COMM HEALTH NETWORK | $161,308 | $161,308 |
| LOSS ON ASSET DISPOSAL | -$71,162 | -$71,162 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $90,146 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,303,437 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,034,895 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $703,841 | TotalAmt |
| Program Services | $264,740 | ProgramServicesAmt |
| Management And General | $439,101 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,392,378 | TotalAmt |
| Program Services | $8,553,456 | ProgramServicesAmt |
| Management And General | $2,838,922 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,748,319 | TotalAmt |
| Program Services | $1,800,576 | ProgramServicesAmt |
| Management And General | $947,743 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $927,865 | TotalAmt |
| Program Services | $681,147 | ProgramServicesAmt |
| Management And General | $246,718 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,197,658 | TotalAmt |
| Program Services | $1,640,503 | ProgramServicesAmt |
| Management And General | $557,155 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,016 | TotalAmt |
| Program Services | $149,119 | ProgramServicesAmt |
| Management And General | $20,897 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630,467 | TotalAmt |
| Program Services | $312,270 | ProgramServicesAmt |
| Management And General | $318,197 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $516,937 | TotalAmt |
| Program Services | $282,660 | ProgramServicesAmt |
| Management And General | $234,277 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,047 | TotalAmt |
| Program Services | $108,246 | ProgramServicesAmt |
| Management And General | $132,801 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,817 | TotalAmt |
| Program Services | $122,528 | ProgramServicesAmt |
| Management And General | $14,289 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,134 | TotalAmt |
| Program Services | $588,134 | ProgramServicesAmt |
| Management And General | $79,000 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,973 | TotalAmt |
| Program Services | $23,091 | ProgramServicesAmt |
| Management And General | $19,882 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,832,054 | $3,832,054 | |
| REPAIR AND MAINT | $296,445 | $273,727 | $22,718 |
| DUES AND LICENSES | $187,440 | $41,298 | $146,142 |
| OTHER | $74,812 | $1,611 | $73,201 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,766,203 | TotalAmt |
| Program Services | $18,675,160 | ProgramServicesAmt |
| Management And General | $6,091,043 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,239,946 | BOYAmt |
| EOY | $4,335,647 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,306,303 | BOYAmt |
| EOY | $479,035 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,544 | BOYAmt |
| EOY | $340,547 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,601,550 | BOYAmt |
| EOY | $1,781,440 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,945 | BOYAmt |
| EOY | $193,984 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,273 | BOYAmt |
| EOY | $269,161 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,266,649 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,042,417 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,563,220 | BOYAmt |
| EOY | $9,224,232 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,000 | BOYAmt |
| EOY | $12,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,212 | BOYAmt |
| EOY | $159,363 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,514,993 | BOYAmt |
| EOY | $16,795,409 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,246,581 | BOYAmt |
| EOY | $1,198,625 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,536,902 | BOYAmt |
| EOY | $183,939 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,258,355 | BOYAmt |
| EOY | $2,563,764 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,041,838 | BOYAmt |
| EOY | $3,946,328 | 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 | $9,473,155 | BOYAmt |
| EOY | $12,849,081 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,473,155 | BOYAmt |
| EOY | $12,849,081 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,514,993 | BOYAmt |
| EOY | $16,795,409 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,537,234 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$161,308 | 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 | $10,311,094 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,821,804 | DepreciationAmt |
| Book Value | $6,489,290 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,273,586 | OtherCostOrOtherBasisAmt |
| Depreciation | $157,879 | DepreciationAmt |
| Book Value | $1,115,707 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,236,948 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,062,734 | DepreciationAmt |
| Book Value | $1,174,214 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,224,232 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $28,235,229 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $93,100 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $93,100 | RevenueNotReportedAmt |
| Revenue Subtotal | $28,142,129 | RevenueSubtotalAmt |
| Other Revenues Not Included | $161,308 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $161,308 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $28,303,437 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,859,303 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $93,100 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $93,100 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,766,203 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $24,766,203 | 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-1 161,308 | 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 (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| MANUEL HERNANDEZ | ||||
| PHYSICIAN | $264,333 | $28,988 | $23,018 | $316,339 |
| JEMELLEE JACALA-TADIAN | ||||
| PHYSICIAN | $270,431 | $34,821 | $3,182 | $308,434 |
| MARION HAUTEA | ||||
| CMO | $264,740 | $35,077 | $6,551 | $306,368 |
| MICHELLE STYMA | ||||
| CEO | $235,555 | $31,699 | $2,958 | $270,212 |
| JEFFREY TAYLOR | ||||
| DENTIST | $233,767 | $27,650 | $5,141 | $266,558 |
| WAYNE MCEWEN | ||||
| PHSICIAN ASSISTANT | $183,060 | $29,522 | $2,801 | $215,383 |
| EMILY HILL | ||||
| DENTIST | $154,446 | $27,177 | $2,976 | $184,599 |
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 COMMUNITY HEALTH NETWORK K-1 -161,308 |