2021-10-29T13:22:08-05:00 2020-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE COURT SUITE 500 AUBURN HILLS MI 48326 990 2020-01-01 382018957 TOTAL HEALTH CARE INC TOTA 3138712000 3011 W GRAND BLVD NO 1600 DETROIT MI 48202 NICHOLAS GATES INTERIM SVP, FINANCE 3138712000 2021-10-26 1 NICHOLAS GATES 999009999 DAVID LOWENTHAL P00378651 2483757100 2021-10-26 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z NICHOLAS GATES 3011 W GRAND BLVD NO 1600 DETROIT MI 48202 189639296 0 X WWW.THCMI.COM X 1973 MI TO IMPROVE HEALTH, INSPIRE HOPE AND SAVE LIVES. 6 1 0 0 0 0 0 0 180666839 189475002 10776928 164294 0 0 191443767 189639296 0 0 172251871 156435860 1000 0 0 0 0 24643808 24187031 196896679 180622891 -5452912 9016405 104297480 91380990 65222548 47513244 39074932 43867746 X TOTAL HEALTH CARE, INC. IS COMMITTED TO EXCELLENCE IN HEALTH CARE DELIVERY IN THE STATE OF MICHIGAN AND THE ASSURANCE THAT ITS MEMBERS HAVE ACCESS TO AND RECEIVE HIGH QUALITY HEALTH CARE AND THE APPROPRIATE PREVENTATIVE SERVICES THAT PROMOTE WELLNESS AND IMPROVED HEALTH STATUS WITHIN THE COMMUNITY. TOTAL HEALTH CARE, INC. SUPPORTS A CONTINUOUS QUALITY IMPROVEMENT PROCESS THAT CONTRIBUTES TO THE OVERALL IMPROVEMENT OF THE MAINSTREAM OF HEALTH CARE DELIVERY IN A COST EFFECTIVE MANNER. TOTAL HEALTH CARE, INC. MAINTAINS AN ORGANIZATIONAL SERVICE PHILOSOPHY OF BEING TOTALLY AVAILABLE AND TOTALLY HELPFUL. 0 0 156435860 189475002 HEALTH MAINTENANCE ORGANIZATION SERVING EXCLUSIVELY A POOR AND INDIGENT POPULATION UNDER THE STATE SPONSORED MEDICAID PROGRAM PROVIDING COMPREHENSIVE MEDICAL SERVICES AND INSURANCE TO APPROXIMATELY 62,013 SUBSCRIBERS. THE ORGANIZATION ALSO: - ASSISTS WITH COMMUNITY, CHURCH AND EMPLOYER SPONSORED HEALTH FAIRS WHICH INCLUDE MANY HEALTH SCREENINGS. PROVIDES MATERIALS TO ATTENDEES FOR VARIOUS HEALTH CONDITIONS AND DISEASES TO ASSIST IN HEALTHIER LIFESTYLES. - EDUCATES INDIVIDUALS ON NUMEROUS DISEASES TO ENABLE MEMBERS TO BETTER CARE FOR THEMSELVES AND IMPROVE THE MANAGEMENT OF THEIR CONDITION.- DISTRIBUTES HEALTH BROCHURES TO COMMUNITY HEALTH FAIRS, EMPLOYER GROUPS AND PHYSICIAN OFFICES.- ENCOURAGES SMOKING CESSATION THROUGH VARIOUS MEANS AND PARTICIPATION IN PROGRAMS OFFERED BY THE STATE. PROVIDES PAYMENT FOR MEDICATIONS TO ASSIST IN THE BREAKING OF ADDICTION.- PUBLISHES THE GOOD HEALTH GAZZETTE ON QUARTERLY BASIS TO THE MEMBERSHIP AND PHYSICIANS CONTAINING ARTICLES ON NUTRITION, WEIGHT LOSS, HEALTH SCREENINGS AND OTHER HEALTHCARE MATTERS.- EDUCATES EXPECTANT MOTHERS RELATED TO THEIR PREGNANCY AND THE CARE AND DEVELOPMENT OF THEIR NEWBORN.- OFFERS MEDICAL INTERNSHIP FOR HIGH SCHOOL STUDENTS TO ENCOURAGE CAREERS IN THE HEALTHCARE PROFESSION, IN COOPERATION WITH WAYNE STATE SCHOOL OF MEDICINE.- ENCOURAGES PARTICIPATION IN A SUPERVISED WEIGHT LOSS PROGRAM FOR ADULTS AND ADOLESCENTS BY PAYING FOR THE WEIGHT WATCHERS PLAN. 156435860 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1973 0 1 0 0 0 0 0 0 0 0 0 X 6 1 1 1 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X SARA MCGLYNN 3132936466 3011 W GRAND BLVD SUITE 1600 DETROIT MI 48202 JOAN BUDDEN DIRECTOR, PRESIDENT & CEO 2.00 48.00 X X 0 1513601 455710 MARY ANNE JONES DIRECTOR, SVP, FINANCE PH/TREASURER 2.00 48.00 X X 0 622101 213867 MICHAEL R KOZIARA SVP, PROVIDER NETWORK 2.00 48.00 X 0 611782 171626 MARTI LOLLI DIRECTOR, SVP, PROVIDER NETWORK 2.00 48.00 X 0 529922 206767 JIANHUA YU SVP, ANALYTICS/ACTUARY 2.00 48.00 X 0 562454 166569 JAMES FORSHEE SVP, CHIEF MEDICAL OFFICER 2.00 48.00 X 0 558781 144227 KIMBERLY THOMAS SVP, GEN. COUNSEL PRIORITY HEALTH/SECRETARY 2.00 48.00 X 0 523215 169453 RICK V MORRONE DIRECTOR, SVP, EMPLOYER SOLUTIONS 2.00 48.00 X 0 538615 123788 RANDY NAROWITZ SVP, TOTAL HEALTH CARE 2.00 48.00 X X 0 651024 22724 NICOLE ROUSH FORMER CFO 0.00 50.00 X 0 248156 35550 NOEL UPFALL ASSOC MEDICAL DIRECTOR 25.00 25.00 X 0 263361 34442 CHRISTOPHER VAN ANTWERP DIRECTOR, HEALTH PLAN INT 25.00 25.00 X 0 233523 35566 NOAH MONRO DIRECTOR, INFO SERVICES 25.00 25.00 X 0 185636 21079 SARA MCGLYNN CONTROLLER 25.00 25.00 X 0 139643 26122 SUSAN RYAN PROVIDER RELATIONS 25.00 25.00 X 0 131932 23895 KRISTALYNN CAMPBELL DIRECTOR 2.00 2.00 X 0 3000 0 0 7316746 1851385 17 1 0 1 ENVISION PHARMACEUTICAL SERVICES 2181 E AURORA RD STE 201 MINNEAPOLIS MN 55401 PHARMACY BENEFITS MANAGEMENT 30829449 PARTNERS FOR HEALTH 882 OAKMAN BLVD DETROIT MI 48238 MEMBERS ASSISTANCE 266531 HUMAN ARC CORPORATION PO BOX 637901 CINCINNATI OH 45263 CLAIMS RECOVERY 156000 VARIS 9245 SIERRA COLLEGE BLVD ROSEVILLE CA 95661 DRG VALIDATION 151429 4 MEDICAID CAPITATION 900099 189475002 189475002 189475002 164294 164294 189639296 189475002 0 164294 156435860 156435860 68608 68608 15758 15758 9000 9000 4736 4736 73658 73658 ADMINISTRATIVE EXPENSES 15084472 15084472 LOSS CONTINGENCY 8814958 8814958 FILING AND BANK FEES 79075 79075 OTHER ADMINSTRATIVE COS 36766 36766 180622891 156435860 24187031 0 34345944 44617406 30761818 11828132 1962487 1972251 37153573 32963201 73658 0 104297480 91380990 65222548 38698286 0 8814958 65222548 47513244 X 0 0 0 0 39074932 43867746 39074932 43867746 104297480 91380990 X 9016405 -4223591 X X 0 1 X 1 0 0 MAINTAINED UNDER STATUTORY REQUIREMENTS 1090124 F INVESTMENT IN SUBSIDIARIES 31873077 C 32963201 PENDING DISPUTE LIABILITY 8814958 8814958 222282934 32643638 32643638 189639296 0 189639296 213266529 32643638 32643638 180622891 0 180622891 PART XI, LINE 2D - OTHER ADJUSTMENTS: INSURANCE PROVIDER ASSESSMENT 32,643,638. PART XII, LINE 2D - OTHER ADJUSTMENTS: INSURANCE PROVIDER ASSESSMENT 32,643,638. 0 1 0 0 0 0 0 0 0 JOAN BUDDEN DIRECTOR, PRESIDENT & CEO 0 884825 0 619389 0 9387 0 329124 0 126586 0 1969311 0 350561 MARY ANNE JONES DIRECTOR, SVP, FINANCE PH/TREASURER 0 467289 0 137240 0 17572 0 121472 0 92395 0 835968 0 51946 MICHAEL R KOZIARA SVP, PROVIDER NETWORK 0 435057 0 158428 0 18297 0 95189 0 76437 0 783408 0 79485 MARTI LOLLI DIRECTOR, SVP, PROVIDER NETWORK 0 411407 0 114571 0 3944 0 132529 0 74238 0 736689 0 39753 JIANHUA YU SVP, ANALYTICS/ACTUARY 0 432638 0 127390 0 2426 0 117044 0 49525 0 729023 0 50335 JAMES FORSHEE SVP, CHIEF MEDICAL OFFICER 0 424342 0 118756 0 15683 0 64950 0 79277 0 703008 0 41883 KIMBERLY THOMAS SVP, GEN. COUNSEL PRIORITY HEALTH/SE 0 405731 0 115861 0 1623 0 111949 0 57504 0 692668 0 42763 RICK V MORRONE DIRECTOR, SVP, EMPLOYER SOLUTIONS 0 412836 0 119794 0 5985 0 75390 0 48398 0 662403 0 46108 RANDY NAROWITZ SVP, TOTAL HEALTH CARE 0 638988 0 3000 0 9036 0 7722 0 15002 0 673748 0 0 NICOLE ROUSH FORMER CFO 0 232467 0 3000 0 12689 0 13496 0 22054 0 283706 0 0 NOEL UPFALL ASSOC MEDICAL DIRECTOR 0 257917 0 3000 0 2444 0 14296 0 20146 0 297803 0 0 CHRISTOPHER VAN ANTWERP DIRECTOR, HEALTH PLAN INT 0 196813 0 28968 0 7742 0 11642 0 23924 0 269089 0 0 NOAH MONRO DIRECTOR, INFO SERVICES 0 182229 0 3000 0 407 0 5482 0 15597 0 206715 0 0 SARA MCGLYNN CONTROLLER 0 136155 0 3000 0 488 0 6326 0 19796 0 165765 0 0 SUSAN RYAN PROVIDER RELATIONS 0 127688 0 3000 0 1244 0 9079 0 14816 0 155827 0 0 SEE SCHEDULE O FOR ADDITIONAL REPORTING. SEE SCHEDULE O FOR ADDITIONAL REPORTING. THE COMPENSATION FOR THE FOLLOWING INDIVIDUALS REPORTED ON PART VII, COLUMN D IS FROM PRIORITY HEALTH MANAGED BENEFITS, INC., A RELATED COMPANY. JOAN BUDDEN, RANDY NAROWITZ, MARY ANNE JONES, KIMBERLY THOMAS, MARTI LOLLI, RICK V. MORRONE, MICHAEL R. KOZIARA, JAMES FORSHEE, JIANHUA YU, NOEL UPFALL MD., CHRISTOPHER VAN ANTWERP, NOAH MONRO, SARA MCGLYNN, AND SUSAN RYAN. SCHEDULE J, PART II, COLUMN (F)- DEFERRED COMPENSATION THE 2020 "BONUS & INCENTIVE COMPENSATION" INCLUDES CERTAIN DEFERRED COMPENSATION ARRANGEMENTS THAT WERE REPORTED IN PREVIOUS YEARS BUT PAID IN 2020. THIS RESULTS IN A CERTAIN AMOUNT OF WAGES BEING REPORTED IN THE FORM 990 TWICE. AMOUNTS REPORTED IN PART II COLUMN F REPRESENT COMPENSATION THAT WAS REPORTED IN A PREVIOUS YEAR'S FORM 990 WHILE ALSO BEING REPORTED IN THE CURRENT FORM 990 AS TOTAL COMPENSATION. SCHEDULE J, PART I, LINE 4B- SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN $ 350,561 JOAN BUDDEN $ 41,883 JAMES FORSHEE $ 51,946 MARY ANNE JONES $ 79,485 MICHAEL KOZIARA $ 39,753 MARTI LOLLI $ 50,335 JIANHUA YU SCHEDULE J, PART I, LINE 4B IS ANSWERED "YES" BECAUSE INDIVIDUALS, WHOSE SALARY AND BENEFITS ARE ALLOCATED TO THIS ORGANIZATION, DO "PARTICIPATE IN" A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. SOME INDIVIDUALS RECEIVED DISTRIBUTIONS DURING THE YEAR (AS REPORTED ON THIS LINE) WHEREAS OTHERS PARTICIPATED IN THE PLAN BUT DID NOT RECEIVE DISTRIBUTIONS. DISTRIBUTIONS REPORTED ON THIS LINE ARE ALSO INCLUDED IN SCHEDULE J, PART II, COLUMN F AS COMPENSATION REPORTED IN A PRIOR YEAR. THE NONQUALIFIED RETIREMENT PLANS ARE AN INDUSTRY STANDARD AND ARE SUBJECT TO THE FUNDING REQUIREMENTS OF NONQUALIFIED DEFERRED COMPENSATION PLANS UNDER ERISA AND FEDERAL TAX REGULATIONS. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING HAVE A BUSINESS RELATIONSHIP: RANDY NAROWITZ, JOAN BUDDEN, MARY ANNE JONES, MARTI LOLLI, RICK MARRONE, KIMBERLY THOMAS, MICHAEL KOZIARA, JAMES FORSHEE AND JIANHUA YU. ALL ARE EMPLOYEES OF SPECTRUM HEALTH. FORM 990, PART VI, SECTION A, LINE 3 THC HAS CONTRACTED WITH PRIORITY HEALTH MANAGED BENEFITS, INC., TO PERFORM THESE FUNCTIONS. THE PERFORMANCE OF THESE SERVICES BY PRIORITY HEALTH MANAGED BENEFITS, INC. IS SUBJECT TO OVERSIGHT BY THE BOARD OF TOTAL HEALTH CARE, INC. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS OF TOTAL HEALTH CARE, INC. WERE MODIFIED IN ORDER TO MAKE PRIORITY HEALTH THE SOLE MEMBER OF TOTAL HEALTH CARE, INC. AND TO ALIGN THE BYLAWS OF TOTAL HEALTH CARE, INC. TO THE FORM AND FORMAT OF THE BYLAWS OF PRIORITY HEALTH'S OTHER SUBSIDIARY ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS PRIORITY HEALTH, INC AS OF 1/1/2020. FORM 990, PART VI, SECTION A, LINE 7A PRIORITY HEALTH, INC., A RELATED 501(C)(4) ORGANIZATION, IS ABLE TO APPOINT THE BOARD OF TOTAL HEALTH CARE, INC. FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS REVIEWED BY THE CONTROLLER, SVP, FINANCE & OPERATIONS AND PRESIDENT OF PRIORITY HEALTH BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C SPECTRUM HEALTH HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES, WHICH REQUIRES DISCLOSURE OF ANY POTENTIAL CONFLICTS. FAILURE TO DO SO PUTS THE EMPLOYEE AT RISK OF TERMINATION. OFFICERS AND BOARD MEMBERS ARE REQUIRED TO ANNUALLY CERTIFY THE CONFLICT OF INTEREST STATEMENT, WHICH ALSO REQUIRES NOTIFICATION TO THE BOARD OF DIRECTORS IF ANY POTENTIAL CONFLICTS ARISE DURING THE YEAR. THE ANNUAL STATEMENTS ARE REVIEWED BY THE EXECUTIVE AND BOARD CHAIR IF THERE ARE CONCERNS ABOUT POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 BEGINNING IN 2017, COMPENSATION FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IS DISCUSSED AND APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION FOR OTHER OFFICERS OR KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE TOP MANAGEMENT OFFICIALS. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATIONAL DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: INCOME FROM SUBSIDIARY EQUITY INVESTMENT - TOTAL HEALTHCARE USA -4,223,591. FORM 990, PART XII, LINE 2C: AS A RESULT OF PRIORITY HEALTH'S ACQUISITION OF THE TOTAL HEALTH CARE, THE PRIORITY HEALTH FINANCE AND AUDIT COMMITTEE ASSUMED RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. 990 PART IV, LINE 12: TOTAL HEALTH CARE, INC. HAS ITS FINANCIAL STATEMENTS AUDITED UNDER THE STATUTORY BASIS OF ACCOUNTING, AS OPPOSED TO UNDER THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) BASIS OF ACCOUNTING. FORM 990, PART VII, COLUMN (D) & SCHEDULE J, PART II, ROW (I): TOTAL HEALTH CARE INC., HAS ENTERED INTO AN ADMINISTRATIVE SERVICES CONTRACT WITH AN ADMINISTRATIVE SERVICES COMPANY, PRIORITY HEALTH MANAGED BENEFITS, INC. ALL SALARIES AND BENEFITS ARE PAID BY THE ADMINISTRATIVE SERVICES COMPANY TO ITS EMPLOYEES WHO PROVIDE SERVICES TO TOTAL HEALTH CARE, INC. THE AMOUNTS SHOWN AS COMPENSATION FOR THE OFFICERS AND EMPLOYEES ON SCHEDULE J ARE THE TOTAL W-2 COMPENSATION FOR THE YEAR. ONLY A PORTION OF THIS COMPENSATION IS ATTRIBUTABLE TO THEIR SERVICES FOR TOTAL HEALTH CARE, INC. THE REMAINING SERVICES ARE ATTRIBUTABLE TO RELATED ENTITIES. PHMB PROPERTIES LLC 1231 EAST BELTLINE NE GRAND RAPIDS MI 49525 382715520 PROP. MGMT MI PRIORITY HEALTH SPECTRUM HEALTH SYSTEM 100 MICHIGAN AVE NE GRAND RAPIDS MI 49503 383382353 MANAGEMENT MI IRC CODE 501(C)(3) 12 TYPE III-FI N/A 0 SPECTRUM HEALTH HOSPITALS 100 MICHIGAN AVE NE GRAND RAPIDS MI 49503 381360529 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 SPECTRUM HEALTH PRIMARY CARE PTNRS 1840 WEALTHY STREET SE GRAND RAPIDS MI 49506 381358164 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 SPECTRUM HEALTH FOUNDATION 100 MICHIGAN AVE NE GRAND RAPIDS MI 49503 382752328 PHILANTHROPY MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 SPECTRUM HEALTH CONTINUING CARE 750 FULLER AVE NE GRAND RAPIDS MI 49503 383242232 REHAB/CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 TRINITY HEALTH PLANS 1231 EAST BELTLINE NE GRAND RAPIDS MI 49525 382663747 HMO MGMT MI IRC CODE 501(C)(4) PRIORITY HEALTH 1 PRIORITY HEALTH CHOICE INC 1231 EAST BELTLINE NE GRAND RAPIDS MI 49525 320016523 HMO (MEDICAID) MI IRC CODE 501(C)(3) PRIORITY HEALTH 1 REED CITY HOSPITAL CORPORATION 300 N PATTERSON RD REED CITY MI 49677 382770076 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION 212 S SULLIVAN AVENUE FREMONT MI 49412 381359517 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 ZEELAND COMMUNITY HOSPITAL 8333 FELCH STREET ZEELAND MI 49464 381411184 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 SPECTRUM HEALTH UNITED 615 S BOWER GREENVILLE MI 48838 381358412 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 MECOSTA COUNTY MEDICAL CENTER 605 OAK STREET BIG RAPIDS MI 49307 381368744 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 MEMORIAL MEDICAL CENTER OF WEST MICHIGAN 1 N ATKINSON DR LUDINGTON MI 49431 381359266 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 PENNOCK HOSPITAL 1009 WEST GREEN STREET HASTINGS MI 49058 381360562 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 LAKELAND REGIONAL HEALTH SYSTEM INC 1234 NAPIER AVE SAINT JOESPH MI 49085 382609624 HEALTH CARE MI IRC CODE 501(C)(3) SPECTRUM HEALTH SYSTEM 0 TOTAL HEALTH CARE USA INC 3011 W GRAND BLVD SUITE 1600 DETROIT MI 48202 383240485 HMO MI IRC CODE 501(C)(4) TOTAL HEALTH CARE INC 0 PRIORITY HEALTH 1231 EAST BELTLINE NE GRAND RAPIDS MI 49525 382715520 HMO MI IRC CODE 501(C)(4) SPECTRUM HEALTH SYSTEM 0 WEST MICHIGAN ACCOUNTABLE CARE ORGANIZATION LLC 221 MICHIGAN ST NE STE 501 GRAND RAPIDS MI 49503 833153113 ACCOUNTABLE CARE ORGANIZATION MI SPECTRUM HEALTH SYSTEM RELATED 0 0 PRIORITY HEALTH INSURANCE COMPANY 1231 EAST BELTLINE GRAND RAPIDS MI 49525 201529553 INSURANCE MI PRIORITY HEALTH C 1 PRIORITY HEALTH MANAGED BENEFITS 1231 EAST BELTLINE GRAND RAPIDS MI 49525 383085182 THIRD PARTY ADMINISTRATOR MI N/A C 0 WEST MICHIGAN HEART 1840 WEALTHY STREET GRAND RAPIDS MI 49506 382125186 PHYSICIANS MI N/A C 0 SPECTRUM HEALTH PHYSICIAN ALLIANCE 100 MICHIGAN AVE NE GRAND RAPIDS MI 49503 371655728 PHYSICIANS MI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 TOTAL HEALTH CARE USA INC Q 10377727 ACTUAL COSTS