LAKESHORE AREA RADIATION ONCOLOGY CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
LAKESHORE AREA RADIATION ONCOLOGY CENTER (EIN 38-3067954)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-02-14
IRS object ID
202040459349300814
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2020-02-14T09:30:08-06:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135381590PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 OTTAWA AVE NW SUITE 300AddressLine1Txt
CityGRAND RAPIDSCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49503ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN383067954EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Lakeshore Area Radiation Oncology CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLAKEBusinessNameControlTxt
Phone6167745083PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112642 Riley STAddressLine1Txt
CityHollandCityNm
State AbbreviationMIStateAbbreviationCd
ZIP494249202ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBrenda WinnPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2020-02-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJACOB COOKPreparerPersonNm
PTINP01240455PTIN
Phone6167747000PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Mr Joseph KlesneyBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line112642 Riley STAddressLine1Txt
CityHollandCityNm
State AbbreviationMIStateAbbreviationCd
ZIP494249202ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,380,484GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.lakeshoreradiation.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionThe Lakeshore Area Radiation Oncology Center is a cooperative venture by three West Michigan hospitals designed to serve lakeshore area residents and improve the health of the area. Holland Community Hospital, Spectrum Health Hospitals and Zeeland Community Hospital comprise the members of the Lakeshore Area Radiation Oncology Center. Our mission is to provide convenient, technologically advanced, and cost effective radiation oncology services in a comfortable and compassionate environment that reaches beyond the traditional hospital walls. Our commitment is to treat those whom we serve with dignity and respect. We intend to provide individualized care, educational resources and support to our patients and their families, sharing in their sense of hope for the future.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$1,800CYContributionsGrantsAmt
PY Program Service Revenue$3,719,513PYProgramServiceRevenueAmt
CY Program Service Revenue$5,338,915CYProgramServiceRevenueAmt
PY Investment Income$8,678PYInvestmentIncomeAmt
CY Investment Income$24,982CYInvestmentIncomeAmt
PY Other Revenue$14,431PYOtherRevenueAmt
CY Other Revenue$14,787CYOtherRevenueAmt
PY Total Revenue$3,742,622PYTotalRevenueAmt
CY Total Revenue$5,380,484CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,557,136PYOtherExpensesAmt
CY Other Expenses$2,524,466CYOtherExpensesAmt
PY Total Expenses$2,557,136PYTotalExpensesAmt
CY Total Expenses$2,524,466CYTotalExpensesAmt
PY Revenues Less Expenses$1,185,486PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,856,018CYRevenuesLessExpensesAmt
Total Assets BOY$4,945,575TotalAssetsBOYAmt
Total Assets EOY$3,945,519TotalAssetsEOYAmt
Total Liabilities BOY$347,206TotalLiabilitiesBOYAmt
Total Liabilities EOY$649,338TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,598,369NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,296,181NetAssetsOrFundBalancesEOYAmt
MissionLakeshore Area Radiation Oncology Center was established to deliver outpatient radiation services, a health care service for the general public.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,029,825ExpenseAmt
Revenue$5,353,702RevenueAmt
DescTHE LAKESHORE AREA RADIATION ONCOLOGY CENTER ("LAROC") PROVIDES CONVENIENT AND TECHNOLOGICALLY ADVANCED RADIATION ONCOLOGY SERVICES AND EDUCATIONAL RESOURCES TO AREA RESIDENTS. DURING THE YEAR LAROC PROVIDED 6,713 RADIATION ONCOLOGY TREATMENTS ON AN OUTPATIENT BASIS TO 309 PATIENTS.Desc
Total Program Service Expenses$2,029,825TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
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Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LESLIE FLAKEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6167745083PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 Michigan Ave NEAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49503ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Joseph Klesney
PRESIDENT1.049.0Yes (X)Yes (X)$0$182,498$31,520
Angela Ditmar
Vice President - PART YEAR0.349.7Yes (X)Yes (X)$0$311,430$67,804
Mark Pawlak
Secretary0.30Yes (X)Yes (X)$0$0$0
Brenda Winn
Treasurer0.30Yes (X)Yes (X)$0$0$0
Ron Lewis
DIRECTOR0.349.7Yes (X)$0$395,501$126,260
Ryan Powers
DIRECTOR0.349.7Yes (X)$0$193,009$30,322
Mary Kay Vandriel
DIRECTOR0.349.7Yes (X)$0$398,318$107,725
FieldValueIRS element (for citing)
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Tot Reportable Comp Rltd Org$1,480,756TotReportableCompRltdOrgAmt
Total Other Compensation$363,631TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SPECTRUM HEALTH
100 MICHIGAN ST NEGRAND RAPIDSMI49503MANAGEMENT SERVICES$1,585,927
VARIAN MEDICAL SYSTEMS
660 N MCCARTHY BLVDMILPITASCA95035MAINTENANCE CONTRACT - RADIATION$208,609
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$1,800AllOtherContributionsAmt
Total Contributions$1,800TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRadiation Oncology ServicesDesc
Business621498BusinessCd
Total Revenue Column$5,338,915TotalRevenueColumnAmt
Related Or Exempt Func Income$5,338,915RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$5,338,915TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,982TotalRevenueColumnAmt
Exclusion$24,982ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$14,787RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$14,787RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,787TotalRevenueColumnAmt
Related Or Exempt Func Income$14,787RelatedOrExemptFuncIncomeAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

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Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,380,484TotalRevenueColumnAmt
Related Or Exempt Func Income$5,353,702RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$24,982ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,550,617TotalAmt
Program Services$1,138,308ProgramServicesAmt
Management And General$412,309ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,085TotalAmt
Program Services$6,085ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$50,192TotalAmt
Management And General$50,192ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$114,049TotalAmt
Program Services$111,059ProgramServicesAmt
Management And General$2,990ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$437,749TotalAmt
Program Services$421,991ProgramServicesAmt
Management And General$15,758ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,730TotalAmt
Program Services$3,175ProgramServicesAmt
Management And General$555ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$306,994TotalAmt
Program Services$294,157ProgramServicesAmt
Management And General$12,837ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$35,642TotalAmt
Program Services$35,642ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Medical Supplies$15,288$15,288
Other Operating Expense$3,950$3,950
Educational Materials$170$170

All Other Expenses AllOtherExpensesGrp

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Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

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Total$2,524,466TotalAmt
Program Services$2,029,825ProgramServicesAmt
Management And General$494,641ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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BOY$200BOYAmt
EOY$200EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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BOY$2,529,419BOYAmt
EOY$1,493,543EOYAmt

Accounts Receivable AccountsReceivableGrp

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BOY$335,733BOYAmt
EOY$160,440EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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BOY$0BOYAmt
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BOY$213,291BOYAmt
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Land Bldg Equip Cost Or Other Bss$13,092,769LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,885,120LandBldgEquipAccumDeprecAmt

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BOY$1,866,932BOYAmt
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Investments Program Related InvestmentsProgramRelatedGrp

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Other Assets Total OtherAssetsTotalGrp

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Total Assets TotalAssetsGrp

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EOY$3,945,519EOYAmt

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BOY$776BOYAmt
EOY$64,641EOYAmt

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EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

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BOY$346,430BOYAmt
EOY$584,697EOYAmt

Total Liabilities TotalLiabilitiesGrp

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BOY$347,206BOYAmt
EOY$649,338EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

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BOY$4,598,369BOYAmt
EOY$3,296,181EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

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BOY$4,598,369BOYAmt
EOY$3,296,181EOYAmt

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BOY$4,945,575BOYAmt
EOY$3,945,519EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,856,018ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$4,158,206OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

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Total$0TotalAmt

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Total Calendar Year170 TotalCalendarYear170Grp

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Gross Investment Income170 GrossInvestmentIncome170Grp

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Total$0TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

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Other Income170 OtherIncome170Grp

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Total$0TotalAmt
FieldValueIRS element (for citing)
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Gross Investment Income509 GrossInvestmentIncome509Grp

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Total$0TotalAmt

Post1975 UBTI Post1975UBTIGrp

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Total$0TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

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Total$0TotalAmt

Other Income509 OtherIncome509Grp

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Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090PublicSupportCY509Pct
Investment Income CY0InvestmentIncomeCYPct
Private Foundation509Yes (X)PrivateFoundation509Ind

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
CY Adj Net Income Distributable$0CYAdjNetIncomeDistributableAmt
CY Pct85 Adjusted Net Income$0CYPct85AdjustedNetIncomeAmt
CY Total Min Ast Distributable$0CYTotalMinAstDistributableAmt
CY Greater Adjusted Minimum$0CYGreaterAdjustedMinimumAmt
CY Income Tax Imposed PY$0CYIncomeTaxImposedPYAmt
CY Distributable As Adjusted$0CYDistributableAsAdjustedAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$302,634OtherCostOrOtherBasisAmt
Book Value$302,634BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,602,005OtherCostOrOtherBasisAmt
Depreciation$3,453,498DepreciationAmt
Book Value$1,148,507BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,023,008OtherCostOrOtherBasisAmt
Depreciation$7,318,180DepreciationAmt
Book Value$704,828BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$165,122OtherCostOrOtherBasisAmt
Depreciation$113,442DepreciationAmt
Book Value$51,680BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,207,649TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to memberDesc
Amt$584,697Amt
FieldValueIRS element (for citing)
Total Liability$584,697TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joseph Klesney
PRESIDENT$0$147,258$0$34,125$0$1,115$0$8,325$0$23,195$0$214,018$0$0
Angela Ditmar
Vice President - PART YEAR$0$231,925$0$77,040$0$2,465$0$13,231$0$54,573$0$379,234$0$0
Ron Lewis
DIRECTOR$0$281,415$0$110,597$0$3,489$0$66,747$0$59,513$0$521,761$0$33,274
Ryan Powers
DIRECTOR$0$156,504$0$35,334$0$1,171$0$8,881$0$21,441$0$223,331$0$0
Mary Kay Vandriel
DIRECTOR$0$285,975$0$108,170$0$4,173$0$55,766$0$51,959$0$506,043$0$29,341

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1a Number Reported in Box 3 of Form 1096Pursuant to a shared services contract with a member organization, vendors are processed and paid by the member organization. Amounts paid to the member organization by the filing organization are detailed on Lines 11 - 24 of Part IX.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialsThe organization did not have a process for determining compensation of the top management official or other officers or key employees as the organization did not employ any officers or key employees.
Form 990, Part VI, Line 3 Delegation of management dutiesThe organization has a shared services agreement with Spectrum Health Hospitals, a member organization. Spectrum Health analyzes and prepares the budget for the organization. Spectrum Health also provides the organization with a manager to oversee the facility's operations.
Form 990, Part VI, Line 4 Significant changes to organizational documentsThe organization's bylaws were amended after former member North Ottawa Community Hospital sold its interest to the other members during fiscal year 2018.
Form 990, Part VI, Line 6 Classes of members or stockholdersThe Organization has three members/stockholders as follows: -Spectrum Health Hospitals (EIN 38-1360529), a Michigan nonprofit corporation. -Holland Community Hospital (EIN 38-2800065), a Michigan nonprofit corporation. -Zeeland Community Hospital (EIN 38-1411184), a Michigan nonprofit corporation.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyThe member(s) (see Form 990, Part VI, Line 6) of the Organization appoint(s) all members of the Board of Directors. No individual person shall be eligible to become a Member of the Corporation, and no corporation or other entity shall be eligible to become a Member in the Corporation unless such corporation or entity is an acute care hospital located in Kent, Allegan, Ottawa, or Muskegon Counties, Michigan. Additional Members may be admitted to the Corporation upon the approval of the existing Members holding at least 80% of the weighted votes as outlined in the bylaws: Spectrum Health Hospitals - 41.2% Holland Community Hospital - 41.2% Zeeland Community Hospital - 17.6% The business and affairs of the Organization shall be managed exclusively by a Board of Directors. There shall be six directors of the corporation. Each of the three members of the corporation shall select two directors. The weighted votes of each pair of directors may be cast by only one of the pair if both are not present at a meeting of the board. If both are present at a meeting of the board, they shall each have a vote equal to one-half of the percentages set forth above. Each director shall hold office until his death, resignation, incapacity to act, or removal. In the event any vacancy shall occur on the board of directors, such vacancy shall be filled by the member of the corporation which had originally appointed that director.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersThe members (see Form 990, Part VI, Line 6) of the Organization have the reserved powers set forth below, and shall not be deemed authorized unless and until approved by at least 80% of the weighted votes (see Form 990, Part VI, Line 7a) of the members: -All matters requiring membership action under Michigan law; -Amendment of the Articles of Incorporation or Bylaws of the Organization; -Ratification of the mission, role, and goals of the Organization; -Adoption, approval, revocation, or abandonment of any plan of dissolution of the Organization; and -Adoption, approval, revocation, or abandonment of any plan of merger, consolidation, sale of all or substantially all of the assets and property of the Organization.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyA copy of the Form 990 is provided to the Board of Directors prior to filing. The review process for this Form 990 is as follows: 1. Preparation of the return is supervised and reviewed by a member organization's Corporate Tax Department. 2. A second review is performed by an external CPA firm with expertise in tax-exempt return preparation. 3. The return is reviewed by the organization's Treasurer and Secretary and shared with the members of the Board of Directors.
Form 990, Part VI, Line 12c Conflict of interest policyBOARD OF DIRECTORS 1. Conflicts of interest must be disclosed, BOTH VIA AN ANNUAL ELECTRONIC DISCLOSURE PROCESS as well as verbally at a board meeting prior to discussion of any agenda item with regard to which a board member has a conflict. 2. A person having a financial interest in a proposed transaction or arrangement may make a presentation at a meeting of the Board of Directors or committee considering that transaction or arrangement, but after that presentation he or she shall leave the meeting during discussion and voting on that proposed transaction or arrangement. The person having the financial interest shall not be counted in determining whether a quorum is present. 3. The chairperson of the Board of Directors or committee shall, if appropriate, appoint a disinterested person or committee (including outside advisors) to investigate alternatives to the proposed transaction or arrangement, and to advise whether the proposed transaction or arrangement is in the organization's best interest. 4. The Board of Directors or committee shall exercise due diligence to determine whether the organization can, with reasonable efforts, obtain a more advantageous transaction or arrangement that would not give rise to a conflict of interest. 5. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board of Directors or committee shall determine by a majority vote of the disinterested directors and members whether the proposed transaction or arrangement is in the organization's best interest and for its own benefit and whether the transaction is fair and reasonable to the organization, and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 6. The minutes of the meetings of the Board of Directors and all of the organization's committees shall set forth: a)The names of the persons who disclosed a financial interest in a proposed transaction or arrangement involving the organization or any of its subsidiaries and the nature of the financial interest; and b)The names of the persons who were present for discussions and votes relating to such transaction or arrangement, including any discussion of alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection with that matter. The votes of individual members need not be recorded unless otherwise directed by the Board of Directors or committee. 7. There is an ongoing requirement that members of the board of directors complete another disclosure questionnaire at any point during his/her tenure on the board of directors when a new potential conflict of interest arises. If a member of the board of directors completes a disclosure questionnaire as a result of a new potential conflict of interest, that disclosure questionnaire is submitted to the conflicts of interest committee, which is comprised of individuals from legal, organizational integrity, internal audit, human resources, and members of leadership for review. MANAGEMENT 1. Upon acceptance of an employment offer, each member of management completes a conflict of interest disclosure questionnaire. A copy of the member of management's disclosure questionnaire is sent to the organization's organizational integrity department. A copy of the member of management's disclosure is reviewed by the organization's COI coordinator and escalated to the Conflicts of Interest Committee if necessary. 2. Annually, each member of management completes an annual conflict of interest disclosure questionnaire electronically. The disclosure questionnaire is reviewed by the conflicts of interest committee, which is comprised of individuals from legal, organizational integrity, internal audit, human resources, and members of leadership. 3. There is an ongoing requirement that members of management complete another disclosure questionnaire at any point during his/her employment when a new potential conflict of interest arises. If a member of management completes a disclosure questionnaire as a result of a new potential conflict of interest, that disclosure questionnaire is submitted to the conflicts of interest committee. 4. The conflicts of interest committee, in consultation with executive management, determines how any reported conflicts should be managed. Management of a conflict may take a variety of different forms from implementation of a management plan to requiring that the member of management cease the activity creating the conflict or, in extreme cases, leave the organization's employment. Management is determined on an individual basis based upon the facts and circumstances surrounding the disclosure. The purpose of conflict management is to provide transparency within the organization and to ensure that the organization's employees are always acting in the best interest of the organization.
Form 990, Part VI, Line 19 Required documents available to the publicThe organization's Articles of Incorporation have been provided to the State of Michigan and are available to the public on the State's website. The organization's Bylaws and internal policies are generally not made available to the public. At the time of this filing, the financial statements have not been made available to the public but are represented in Parts VIII, IX, and X of this Form 990.
Form 990, Part IX, Line 11g Other FeesLeased Employees - Total Expense: 1154424, Program Service Expense: 847463, Management and General Expenses: 306961, Fundraising Expenses: ; Other Purchased Services - Total Expense: 158417, Program Service Expense: 116294, Management and General Expenses: 42123, Fundraising Expenses: ; Other Professional Services - Total Expense: 237776, Program Service Expense: 174551, Management and General Expenses: 63225, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesMember Hospital Distributions - -4158206;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
SPECTRUM HEALTH SYSTEM
100 MICHIGAN AVE NEGRAND RAPIDSMI49503383382353MANAGEMENTMI501(c)(3)Type III-FINAfalse
SPECTRUM HEALTH HOSPITALS
100 MICHIGAN ST NEGRAND RAPIDSMI49503381360529HEALTHCAREMI501(c)(3)3SPECTRUM HEALTH SYSTEMfalse
ZEELAND COMMUNITY HOSPITAL
8333 FELCH STREETZEELANDMI49464381411184HEALTHCAREMI501(c)(3)3SPECTRUM HEALTH SYSTEMfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SPECTRUM HEALTH HOSPITALS
P$1,217,247GAAP, CASH, OR FMV
SPECTRUM HEALTH SYSTEM
M$384,665GAAP, CASH, OR FMV

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