MIDMICHIGAN GLADWIN PINES: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MIDMICHIGAN GLADWIN PINES (EIN 38-2754875)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-15
IRS object ID
201711359349310721
Schema version
2015v3.0
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

FieldValueIRS element (for citing)
Return2017-05-15T16:17:57-04:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN383133790PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ANDREWS HOOPER PAVLIK PLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15300 GRATIOT RDAddressLine1Txt
CitySAGINAWCityNm
State AbbreviationMIStateAbbreviationCd
ZIP486386035ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN382754875EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN GLADWIN PINESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMIDMBusinessNameControlTxt
Phone9898393181PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14000 WELLNESS DRAddressLine1Txt
CityMIDLANDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48670ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFRANCINE M PADGETTPersonNm
Person TitleSR. VP & TREASURERPersonTitleTxt
Phone9898393181PhoneNum
Signature2017-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA M EBELPreparerPersonNm
PTINP00184232PTIN
Phone9894975300PhoneNum
Preparation2017-05-15PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerCAROLE CALVERT-BAXTERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13007 N SAGINAW RDAddressLine1Txt
CityMIDLANDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48640ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,336,729GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MIDMICHIGAN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. FORM 990, PART I, LINE 1 & PART III, LINE 1 - ORGANIZATION'S VISION IT IS OUR VISION TO CELEBRATE THE POWER OF HEALTH THROUGHOUT LIFE-WITH YOU.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee134TotalEmployeeCnt
Total Volunteers26TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,480PYContributionsGrantsAmt
CY Contributions Grants$275CYContributionsGrantsAmt
PY Program Service Revenue$6,609,564PYProgramServiceRevenueAmt
CY Program Service Revenue$4,194,372CYProgramServiceRevenueAmt
PY Investment Income-$835PYInvestmentIncomeAmt
CY Investment Income-$3,138CYInvestmentIncomeAmt
PY Other Revenue$155,703PYOtherRevenueAmt
CY Other Revenue$141,256CYOtherRevenueAmt
PY Total Revenue$6,765,912PYTotalRevenueAmt
CY Total Revenue$4,332,765CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,240,117PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,230,401CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,097,351PYOtherExpensesAmt
CY Other Expenses$2,656,249CYOtherExpensesAmt
PY Total Expenses$8,337,468PYTotalExpensesAmt
CY Total Expenses$5,886,650CYTotalExpensesAmt
PY Revenues Less Expenses-$1,571,556PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,553,885CYRevenuesLessExpensesAmt
Total Assets BOY$2,523,387TotalAssetsBOYAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities BOY$2,205,686TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$317,701NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. FORM 990, PART I, LINE 1 & PART III, LINE 1 - ORGANIZATION'S VISION IT IS OUR VISION TO CELEBRATE THE POWER OF HEALTH THROUGHOUT LIFE-WITH YOU.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$5,268,555ExpenseAmt
Revenue$4,194,372RevenueAmt
DescMIDMICHIGAN GLADWIN PINES PROVIDED SKILLED LONG TERM CARE TO THE CITY OF GLADWIN, GLADWIN COUNTY, AND SURROUNDING AREAS. CARE WAS PROVIDED REGARDLESS OF PATIENTS ABILITY TO PAY. UTILIZATION IN FISCAL YEAR 2016 WAS 16,676 PATIENT DAYS.Desc
Total Program Service Expenses$5,268,555TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
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
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationYes (true)PartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee134EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
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 BodyfalseForm990ProvidedToGvrnBodyInd
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 CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonFM PADGETT SR VP TREASURERPersonNm
Phone9898393181PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14000 WELLNESS DRIVEAddressLine1Txt
CityMIDLANDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48670ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DIANE POSTLER-SLATTERY
DIRECTOR2.0050.00Yes (X)$0$1,064,088$184,566
GREGORY ROGERS
CHAIR2.0050.00Yes (X)$0$682,236$243,689
JAMES BICKNELL MD
DIRECTOR2.0050.00Yes (X)$0$444,382$80,730
MARK SANTAMARIA
DIRECTOR2.0050.00Yes (X)$0$436,100$62,194
RAYMOND STOVER
DIRECTOR2.0050.00Yes (X)$0$361,792$143,446
SEAN KESTERSON MD
DIRECTOR2.0050.00Yes (X)$0$310,432$31,123
JANICE PENNEY
DIRECTOR2.0050.00Yes (X)$0$290,441$164,782
PANKAJ JANDWANI MD
DIRECTOR2.0050.00Yes (X)$0$265,742$12,912
ROBIN WHITMORE
DIRECTOR2.0050.00Yes (X)$0$225,310$14,002
GLENN KING
DIRECTOR2.0050.00Yes (X)$0$189,477$24,290
ANN DULL
DIRECTOR2.0050.00Yes (X)$0$147,123$33,470
CAROLE CALVERT-BAXTER
INTERIM PRES2.0050.00Yes (X)$0$142,144$40,940Yes (X)
MARY GREELEY
DIRECTOR2.0050.00Yes (X)$0$137,591$37,055
RACHEL AULTMAN
VICE CHAIR2.0050.00Yes (X)$0$111,518$21,389
CHRISTINE CHESNY
FORMER PRESI0.000.00$0$195,674$36,326Yes (X)
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$5,004,050TotReportableCompRltdOrgAmt
Total Other Compensation$1,130,914TotalOtherCompensationAmt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$275AllOtherContributionsAmt
Total Contributions$275TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID623000$4,028,300$4,028,300
NET PATIENT REVENUE623000$166,072$166,072
FieldValueIRS element (for citing)
Total Program Service Revenue$4,194,372TotalProgramServiceRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$826OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$3,964OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$3,138OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,138TotalRevenueColumnAmt
Exclusion-$3,138ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA/FOOD SERVICE722514$82,511$82,511
SUBSIDIARY RELATED INCOME517000$52,500$52,500
ALL OTHER REVENUE900099$6,245$6,245
FieldValueIRS element (for citing)
Other Revenue Total$141,256OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,332,765TotalRevenueColumnAmt
Related Or Exempt Func Income$4,246,872RelatedOrExemptFuncIncomeAmt
Exclusion$85,618ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,445,425TotalAmt
Program Services$2,170,835ProgramServicesAmt
Management And General$274,590ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$33,326TotalAmt
Program Services$28,262ProgramServicesAmt
Management And General$5,064ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$559,883TotalAmt
Program Services$508,496ProgramServicesAmt
Management And General$51,387ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$191,767TotalAmt
Program Services$171,917ProgramServicesAmt
Management And General$19,850ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$12,352TotalAmt
Management And General$12,352ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,069TotalAmt
Management And General$3,069ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,030,250TotalAmt
Program Services$921,585ProgramServicesAmt
Management And General$108,665ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$384,193TotalAmt
Program Services$373,358ProgramServicesAmt
Management And General$10,835ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$174,589TotalAmt
Program Services$131,989ProgramServicesAmt
Management And General$42,600ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,524TotalAmt
Program Services$7,068ProgramServicesAmt
Management And General$456ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$570TotalAmt
Program Services$420ProgramServicesAmt
Management And General$150ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$140,240TotalAmt
Program Services$88,737ProgramServicesAmt
Management And General$51,503ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$92,083TotalAmt
Program Services$71,445ProgramServicesAmt
Management And General$20,638ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
QAAP (MEDICAID FEES)$467,718$467,718
MEDICAL SUPPLIES$274,214$274,214
EQUIPMENT RENTAL & MAINT$69,447$52,511$16,936

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,886,650TotalAmt
Program Services$5,268,555ProgramServicesAmt
Management And General$618,095ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$600BOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$381,117BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$971,891BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,451BOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,162,328BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,523,387BOYAmt
EOY$0EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$410,854BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,794,832BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,205,686BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$311,658BOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,043BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$317,701BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,523,387BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,553,885ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,236,184OtherChangesInNetAssetsAmt
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)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,235CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,575CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,270CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,480CurrentTaxYearMinus1YearAmt
Current Tax Year$275CurrentTaxYearAmt
Total$8,835TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,121,034CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,142,485CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,331,526CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,609,564CurrentTaxYearMinus1YearAmt
Current Tax Year$4,194,372CurrentTaxYearAmt
Total$35,398,981TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,543CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,838CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,156CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$89,703CurrentTaxYearMinus1YearAmt
Current Tax Year$88,756CurrentTaxYearAmt
Total$277,996TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,124,812CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,148,898CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,427,952CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,700,747CurrentTaxYearMinus1YearAmt
Current Tax Year$4,283,403CurrentTaxYearAmt
Total$35,685,812TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$3,941CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,051CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$509,275CurrentTaxYearMinus1YearAmt
Current Tax Year$888,949CurrentTaxYearAmt
Total$1,441,216TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$3,941CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,051CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$509,275CurrentTaxYearMinus1YearAmt
Current Tax Year$888,949CurrentTaxYearAmt
Total$1,441,216TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$34,244,596PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30,421CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,031CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,559CurrentTaxYearMinus2YearsAmt
Total$58,011TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$30,421CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,031CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,559CurrentTaxYearMinus2YearsAmt
Total$58,011TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,872CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$391,190CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$438,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$66,000CurrentTaxYearMinus1YearAmt
Current Tax Year$52,500CurrentTaxYearAmt
Total$949,562TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,157,105CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,560,119CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,873,511CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,766,747CurrentTaxYearMinus1YearAmt
Current Tax Year$4,335,903CurrentTaxYearAmt
Total$36,693,385TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.93330PublicSupportCY509Pct
Public Support PY5090.96230PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 12FormAndLineReferenceDesc
ExplanationEXEMPT SUBSIDIARY REVENUE 949,562ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Rev Etc Audited Fincl Stmt$4,335,628TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$275NetUnrealizedGainsInvstAmt
Revenue Not Reported-$275RevenueNotReportedAmt
Revenue Subtotal$4,335,903RevenueSubtotalAmt
Other Revenues Not Included-$3,138OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$3,138RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,332,765TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,889,788TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$5,889,788ExpensesSubtotalAmt
Other Expenses Not Included-$3,138OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$3,138ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,886,650TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 4BLOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -3,138
SCHEDULE D, PAGE 4, PART XII, LINE 4BLOSS ON DISPOSAL OF FIXED ASSETS - RECLASSIFIED -3,138

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
DIANE POSTLER-SLATTERY
DIRECTOR$697,400$343,002$23,686$161,889$22,677$1,248,654
GREGORY ROGERS
CHAIR$456,720$192,987$32,529$222,835$20,854$925,925
JAMES BICKNELL MD
DIRECTOR$326,532$114,975$2,875$61,942$18,788$525,112
MARK SANTAMARIA
DIRECTOR$311,508$108,501$16,091$48,465$13,729$498,294
RAYMOND STOVER
DIRECTOR$253,412$89,777$18,603$122,386$21,060$505,238
SEAN KESTERSON MD
DIRECTOR$269,012$40,527$893$13,265$17,858$341,555
JANICE PENNEY
DIRECTOR$225,715$62,754$1,972$150,916$13,866$455,223
PANKAJ JANDWANI MD
DIRECTOR$186,853$78,292$597$5,315$7,597$278,654
ROBIN WHITMORE
DIRECTOR$179,406$37,473$8,431$11,290$2,712$239,312
GLENN KING
DIRECTOR$149,515$32,301$7,661$9,706$14,584$213,767
ANN DULL
DIRECTOR$116,705$25,426$4,992$15,511$17,959$180,593
CAROLE CALVERT-BAXTER
INTERIM PRESIDENT$116,669$24,347$1,128$26,512$14,428$183,084
MARY GREELEY
DIRECTOR$113,229$24,002$360$21,495$15,560$174,646
CHRISTINE CHESNY
FORMER PRESIDENT$104,739$84,622$6,313$27,039$9,287$232,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationPOSTLER-SLATTERY, ROGERS, SANTAMARIA, STOVER, AND BICKNELL ARE PARTICIPANTS IN A 457(F) PLAN. NO PAYMENTS WERE MADE TO THESE PARTICIPANTS IN 2015. THE SERP IS UNFUNDED AND BEGAN JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANTS ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403 (B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, PROVIDED THEY HAVE BEEN EMPLOYED AT LEAST FIVE YEARS AND THE PARTICIPANT EARNS 75 POINTS. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE INDEPENDENT COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE COMPENSATION COMMITTEE, WHO IS AUTHORIZED TO ACT ON BEHALF OF THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS, APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, SENIOR EXECUTIVES AND PHYSICIANS. SULLIVAN COTTER ISSUED A COMPREHENSIVE ASSESSMENT IN 2009 AND AGAIN IN 2013. IN ADDITION, AS A PART OF THE PHYSICIAN ENTERPRISE ENGAGEMENT, KAUFMAN HALL ISSUED A SAFE HARBOR LETTER THAT WAS REVIEWED AT THE JUNE 2013 COMPENSATION COMMITTEE MEETING. PART III - OTHER ADDITIONAL INFORMATION ON MAY 8, 2009 MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE APPROVED ITS FIRST COMPENSATION COMMITTEE CHARTER AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH APPROVED BOTH THE CHARTER AND THE STRATEGY ON JUNE 8, 2009. MIDMICHIGAN HEALTH ALSO CONTINUES TO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED NATIONALLY FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY.ExplanationTxt

Schedule N IRS990ScheduleN

Disposition Of Assets Detail DispositionOfAssetsDetail (7 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
GLADWIN PINES PROPERTY HOLDINGS LLC
BUILDING IMPROVEMENTS2016-05-01$473,020APPRAISAL8113006852532 W CADILLAC DR PO BOX 579FARWELLMI48622LLC
GLADWIN PINES PROPERTY HOLDINGS LLC
BUILDING2016-05-01$342,741APPRAISAL8113006852532 W CADILLAC DR PO BOX 579FARWELLMI48622LLC
GLADWIN PINES PROPERTY HOLDINGS LLC
EQUIPMENT2016-05-01$144,166APPRAISAL8113006852532 W CADILLAC DR PO BOX 579FARWELLMI48622LLC
GLADWIN PINES PROPERTY HOLDINGS LLC
FIXED EQUIPMENT2016-05-01$30,747APPRAISAL8113006852532 W CADILLAC DR PO BOX 579FARWELLMI48622LLC
GLADWIN PINES PROPERTY HOLDINGS LLC
LAND2016-05-01$9,977APPRAISAL8113006852532 W CADILLAC DR PO BOX 579FARWELLMI48622LLC
GLADWIN PINES PROPERTY HOLDINGS LLC
LAND IMPROVEMENTS2016-05-01$21,436APPRAISAL8113006852532 W CADILLAC DR PO BOX 579FARWELLMI48622LLC
MCGUIRE WOODS LLP
LEGAL FEES2016-06-07$127,899FEES540505857800 E CANAL STRICHMONDVA23219LLP
FieldValueIRS element (for citing)
Director Of Successor2falseDirectorOfSuccessor2Ind
Employee Of Successor2falseEmployeeOfSuccessor2Ind
Owner Of Successor2falseOwnerOfSuccessor2Ind
Receive Compensation2falseReceiveCompensation2Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONTO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. FORM 990, PART I, LINE 1 & PART III, LINE 1 - ORGANIZATION'S VISION IT IS OUR VISION TO CELEBRATE THE POWER OF HEALTH THROUGHOUT LIFE-WITH YOU.
FORM 990PART I, LINES 3 & 4 AND PART VI, SECTION A, LINE 1 THOSE MEMBERS WHO ARE NOT INDEPENDENT ARE EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION LISTED IN SCHEDULE R AND ARE COMPENSATED AT MARKET VALUE FOR THE SERVICES PROVIDED TO THAT ORGANIZATION. ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION.
FORM 990, PAGE 2, PART III, LINE 3AS OF MAY 1, 2016, SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION WERE SOLD AND THE OPERATIONS DISCONTINUED. IMMATERIAL RELATED ACTIVITIES MAY CONTINUE UNTIL THE ENTITY IS DISSOLVED. MIDMICHIGAN HEALTH DETERMINED THAT IT DID NOT HAVE THE CRITICAL MASS TO CONTINUE MEETING THE NEEDS OF THE RESIDENTS IN A COST EFFECTIVE MANNER.
FORM 990, PAGE 6, PART VI, LINE 6THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH.
FORM 990, PAGE 6, PART VI, LINE 7ATHE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 7BTHE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE, OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF ANY AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER.
FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 INFORMATION IS PREPARED BY THE FINANCE STAFF AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS ORGANIZATION. THE INFORMATION IS SUBMITTED FOR REVIEW BY A SENIOR FINANCE STAFF MEMBER AT MIDMICHIGAN HEALTH. THE STAFF MEMBER IN CONSULTATION WITH OUR TAX ACCOUNTANT (A CERTIFIED PUBLIC ACCOUNTING FIRM) REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. ONCE THE INITIAL REVIEW IS COMPLETE, THE INFORMATION IS SUBMITTED TO OUR TAX PROFESSIONALS AT ANDREWS HOOPER PAVLIK PLC. UPON REVIEW BY THEIR PROFESSIONALS, INCLUDING A PARTNER, INFORMATION IS RETURNED TO MIDMICHIGAN HEALTH FOR ITS FINAL REVIEW. THIS REVIEW INCLUDES A REVIEW BY THE SVP AND TREASURER. ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE PRIOR TO FILING. FORM 990, INCLUDING ALL SCHEDULES, IS NOT MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS BECAUSE THE BOARD IS COMPRISED OF INTERNAL EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER, THEREFORE, THESE RETURNS ARE REVIEWED BY THE MIDMICHIGAN HEALTH CEO AND CFO PRIOR TO FILING. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND TREASURER.
FORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; 3) TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT INDEPENDENT.
FORM 990, PAGE 6, PART VI, LINE 15ATHE CEO, PRESIDENTS, AND OPERATING OFFICERS COMPENSATION ARE ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.
FORM 990, PAGE 6, PART VI, LINE 15BALL OFFICERS AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J.
FORM 990, PAGE 6, PART VI, LINE 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VIISECTION B, LINE 1 - INDEPENDENT CONTRACTORS INDEPENDENT CONTRACTORS FOR ALL RELATED ORGANIZATIONS ARE COMPENSATED BY MIDMICHIGAN HEALTH, 38-2459948, THE SOLE MEMBER OF THIS ORGANIZATION.
FORM 990, PAGE 7, PART VIINO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A PART-TIME OR FULL-TIME POSITION. AVERAGE HOURS PER WEEK FOR THOSE WITH REPORTABLE COMPENSATION ARE RELATED TO THE AFOREMENTIONED POSITIONS. THOSE PERSONS WITH FULL-TIME POSITIONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES ARE NOT TRACKED BY SUBSIDIARY. THEREFORE THE FULL-TIME SERVICE TO ALL SUBSIDIARIES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS.
FORM 990, PART IX, LINE 11GASSOCIATION DUES & OTHER FEES 43,342 15,001 0 PURCHASED/CONTRACT SERVICES 878,243 93,664 0
FORM 990, PART XI, LINE 9GAIN ON SALE 1,226,333 DISTRIBUTION TO MIDMICHIGAN HEALTH 15,894 NET ASSETS RELEASED FROM RESTRICTION -6,043 TOTAL 1,236,184

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MIDMICHIGAN HEALTH
4000 WELLNESS DRIVEMIDLANDMI48670382459948SUPPORTMI501C311ANAfalse
MIDMICHIGAN MEDICAL CENTER-MIDLAND
4000 WELLNESS DRIVEMIDLANDMI48670380833014HOSPITALMI501C33MIDMI HLTHYes (true)
MIDMICHIGAN MEDICAL CENTER-GRATIOT
300 E WARWICK DRALMAMI48801381437919HOSPITALMI501C33MIDMI HLTHYes (true)
MIDMICHIGAN MEDICAL CENTER-CLARE
703 NORTH MCEWAN STREETCLAREMI48617381518643HOSPITALMI501C33MIDMI HLTHYes (true)
MIDMICHIGAN MEDICAL CENTER-GLADWIN
515 QUARTER STREETGLADWINMI48624386020434HOSPITALMI501C33MIDMI HLTHYes (true)
MIDMICHIGAN MEDICAL CENTER-ALPENA
1501 W CHISHOLM STALPENAMI49707386000029HOSPITALMI501C33MIDMI HLTHYes (true)
MIDMICHIGAN STRATFORD VILLAGE
2121 ROCKWELL DRMIDLANDMI48642382623324LT CAREMI501C39MIDMI HLTHYes (true)
MIDMI VNA DBA MIDMI HOME CARE
3007 N SAGINAW RDMIDLANDMI48640381459397HOME CAREMI501C39MIDMI HLTHYes (true)
MIDMICHIGAN PHYSICIANS GROUP
2620 W SUGNET ROADMIDLANDMI48640383317788MED OFFICEMI501C311AMIDMI HLTHYes (true)
MIDMICHIGAN HEALTH DEV ASSOC
4000 WELLNESS DRIVEMIDLANDMI48670382459947OPERATIONSMI501C2MIDMI HLTHYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MIDMICHIGAN ASSURANCE GROUP LTDBusinessNameLine1Txt

Foreign Address ForeignAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1051 23 LIME TREE BAY AVEAddressLine1Txt
Address Line2GOVERNORS SQUARE BLDG 4 2ND FLOORAddressLine2Txt
CityGEORGE TOWNCityNm
Province Or StateGRAND CAYMANProvinceOrStateNm
CountryCJCountryCd
FieldValueIRS element (for citing)
EIN980585596EIN
Primary ActivitiesINSURANCEPrimaryActivitiesTxt
Legal Domicile Foreign CountryCJLegalDomicileForeignCountryCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MIDMI HLTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPEntityTypeTxt
Controlled OrganizationfalseControlledOrganizationInd
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 OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MIDMICHIGAN HEALTH
P$282,446BOOKS & RECORDS
MIDMICHIGAN MEDICAL CENTER-GLADWIN
Q$52,500BOOKS & RECORDS
MIDMICHIGAN VISITING NURSE ASSOC
R$356,858BOOKS & RECORDS

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE RFormAndLineReferenceDesc
ExplanationPART V, LINE 2(3) AS PART OF THE DISCONTINUED OPERATIONS ALL RECEIVABLES AND LIABILITIES WERE TRANSFERRED TO MIDMICHIGAN VISITING NURSE ASSOCIATION AS OF JUNE 30, 2016. THIS TRANSACTION INCLUDED OUTSTANDING RECEIVABLES OF 427,227 AND OUTSTANDING LIABILITIES OF 70,369.ExplanationTxt

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