MUNSON DIALYSIS CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MUNSON DIALYSIS CENTER (EIN 38-3097861)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201721359349308432
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T15:01:40-04:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383097861 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MUNSON DIALYSIS CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MUNS | BusinessNameControlTxt |
| Phone | 2319355000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1105 SIXTH STREET | AddressLine1Txt |
| City | TRAVERSE CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49684 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK A HEPLER | PersonNm |
| Person Title | VP & CFO | PersonTitleTxt |
| Phone | 2319355000 | PhoneNum |
| Signature | 2017-05-15 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | MARK S DEPONIO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2651 AERO PARK DRIVE | AddressLine1Txt |
| City | TRAVERSE CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49684 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,602,912 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | MUNSON DIALYSIS CENTER PROVIDES RENAL DIALYSIS SERVICES TO THE RESIDENTS OF NORTHERN MICHIGAN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 59 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,000,717 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,602,325 | CYProgramServiceRevenueAmt |
| PY Investment Income | $694 | PYInvestmentIncomeAmt |
| CY Investment Income | -$3,147 | CYInvestmentIncomeAmt |
| PY Other Revenue | $272 | PYOtherRevenueAmt |
| CY Other Revenue | $562 | CYOtherRevenueAmt |
| PY Total Revenue | $6,002,683 | PYTotalRevenueAmt |
| CY Total Revenue | $5,599,740 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,232,604 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,243,157 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,441,679 | PYOtherExpensesAmt |
| CY Other Expenses | $2,709,236 | CYOtherExpensesAmt |
| PY Total Expenses | $4,674,283 | PYTotalExpensesAmt |
| CY Total Expenses | $4,952,393 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,328,400 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $647,347 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,567,767 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,267,534 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $421,574 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $473,994 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,146,193 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,793,540 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MUNSON DIALYSIS CENTER PROVIDES RENAL DIALYSIS SERVICES TO THE RESIDENTS OF NORTHERN MICHIGAN. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,242,009 | ExpenseAmt |
| Revenue | $5,599,715 | RevenueAmt |
| Desc | MUNSON DIALYSIS CENTER PROVIDES RENAL DIALYSIS TREATMENTS TO PATIENTS IN THE MUNSON HEALTHCARE SERVICE AREA. IN TAX YEAR 2015, 23,498 TREATMENTS AND 100 TRAINING PROCEDURES WERE PROVIDED TO PATIENTS. | Desc |
| Total Program Service Expenses | $4,242,009 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 59 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICOLE SULAK MUNSON HEALTHCARE | PersonNm |
| Phone | 2319357777 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4230 COPPER RIDGE DR | AddressLine1Txt |
| City | TRAVERSE CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49684 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| TIMOTHY BINDER | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $261,785 | $43,059 | |
| MARK S DEPONIO | |||||||
| PRESIDENT/CH | 1.00 | 40.00 | Yes (X) | $0 | $244,898 | $32,344 | Yes (X) |
| PETER MARINOFF | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $188,023 | $35,973 | |
| TIMOTHY G FRITZ | |||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $138,935 | $28,783 | |
| STEVE LEACH | |||||||
| SECR/TREAS | 1.00 | 40.00 | Yes (X) | $0 | $131,399 | $27,763 | Yes (X) |
| KEVIN ROGOLS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARK A HEPLER | |||||||
| VP & CFO | 1.00 | 40.00 | $0 | $468,212 | $78,339 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $1,433,252 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $246,261 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AHSA LLC | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 945 | AddressLine1Txt |
| City | TRAVERSE CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49685 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | EMPLOYMENT SERV | ServicesDesc |
| Compensation | $134,494 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE AND MEDICAID PAYMENT | 621990 | $4,340,366 | $4,340,366 |
| RENAL DIALYSIS SERVICES | 621990 | $1,224,136 | $1,224,136 |
| RENT FROM RELATED ORGS | 531120 | $37,823 | $37,823 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,602,325 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25 | TotalRevenueColumnAmt |
| Exclusion | $25 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,172 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,172 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,172 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$3,172 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $562 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $562 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $562 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,599,740 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,599,715 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $25 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,811,399 | TotalAmt |
| Program Services | $1,467,633 | ProgramServicesAmt |
| Management And General | $343,766 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,572 | TotalAmt |
| Program Services | $32,872 | ProgramServicesAmt |
| Management And General | $7,700 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,952 | TotalAmt |
| Program Services | $212,239 | ProgramServicesAmt |
| Management And General | $49,713 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,234 | TotalAmt |
| Program Services | $104,708 | ProgramServicesAmt |
| Management And General | $24,526 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $567,888 | TotalAmt |
| Program Services | $316,149 | ProgramServicesAmt |
| Management And General | $251,739 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,944 | TotalAmt |
| Program Services | $21,511 | ProgramServicesAmt |
| Management And General | $1,433 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,844 | TotalAmt |
| Program Services | $6,836 | ProgramServicesAmt |
| Management And General | $8 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,871 | TotalAmt |
| Program Services | $178,871 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,737 | TotalAmt |
| Program Services | $15,846 | ProgramServicesAmt |
| Management And General | $8,891 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $650 | TotalAmt |
| Program Services | $350 | ProgramServicesAmt |
| Management And General | $300 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,972 | TotalAmt |
| Program Services | $138,958 | ProgramServicesAmt |
| Management And General | $20,014 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,449 | TotalAmt |
| Program Services | $25,899 | ProgramServicesAmt |
| Management And General | $550 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $1,786,533 | $1,786,533 |
| NUTRITION COUNSELING SERV | $20,199 | $20,199 |
| MAINTENANCE AND REPAIR | $12,234 | $12,234 |
| BAD DEBT | $7,462 | $7,462 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$104,547 | TotalAmt |
| Program Services | -$106,291 | ProgramServicesAmt |
| Management And General | $1,744 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,952,393 | TotalAmt |
| Program Services | $4,242,009 | ProgramServicesAmt |
| Management And General | $710,384 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175 | BOYAmt |
| EOY | $175 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,274,135 | BOYAmt |
| EOY | $1,066,998 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $743,071 | BOYAmt |
| EOY | $766,456 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,456,386 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,189,331 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,383,536 | BOYAmt |
| EOY | $1,267,055 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,850 | BOYAmt |
| EOY | $166,850 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,567,767 | BOYAmt |
| EOY | $3,267,534 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,574 | BOYAmt |
| EOY | $298,994 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,000 | BOYAmt |
| EOY | $175,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $421,574 | BOYAmt |
| EOY | $473,994 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,146,193 | BOYAmt |
| EOY | $2,793,540 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,146,193 | BOYAmt |
| EOY | $2,793,540 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,567,767 | BOYAmt |
| EOY | $3,267,534 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $647,347 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,000,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $166,564 | OtherCostOrOtherBasisAmt |
| Book Value | $166,564 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,510,207 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,579,868 | DepreciationAmt |
| Book Value | $930,339 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $696,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $586,174 | DepreciationAmt |
| Book Value | $110,529 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,912 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,289 | DepreciationAmt |
| Book Value | $59,623 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,267,055 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN EVERYGLADS DIALYSIS | Desc |
| Book Value | $166,850 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $166,850 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO THIRD PARTY | Desc |
| Amt | $175,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $175,000 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|
| TIMOTHY BINDER | |||||||
| DIRECTOR | $200,028 | $46,379 | $15,378 | $23,676 | $19,383 | $304,844 | |
| MARK S DEPONIO | |||||||
| PRESIDENT/CHAIR | $181,710 | $43,319 | $19,869 | $23,119 | $9,225 | $277,242 | |
| PETER MARINOFF | |||||||
| DIRECTOR | $156,162 | $31,331 | $530 | $17,561 | $18,412 | $223,996 | |
| TIMOTHY G FRITZ | |||||||
| DIRECTOR | $123,366 | $15,335 | $234 | $7,402 | $21,381 | $167,718 | |
| STEVE LEACH | |||||||
| SECR/TREAS | $116,923 | $14,041 | $435 | $7,015 | $20,748 | $159,162 | |
| MARK A HEPLER | |||||||
| VP & CFO | $333,352 | $103,661 | $31,199 | $54,461 | $23,878 | $546,551 | $8,670 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | TIMOTHY BINDER 0 13,242 0 MARK S. DEPONIO 0 12,216 0 PETER MARINOFF 0 9,660 0 MARK A. HEPLER 0 34,460 0 |
| SCHEDULE J, PART III | SUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | MUNSON DIALYSIS CENTER IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | MUNSON HEALTHCARE, AS THE SOLE MEMBER, ELECTS THE DIRECTORS FOR SUBSIDIARY ENTITIES. NOMINATIONS TO MUNSON HEALTHCARE FOR SUBSIDIARY DIRECTORS ARE CONSIDERED AND RECOMMENDED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. |
| FORM 990, PAGE 6, PART VI, LINE 7B | CERTAIN DECISIONS OF THE MUNSON DIALYSIS CENTER TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACQUISITION OF OR THE ESTABLISHMENT OF ANY SUBSIDIARY OR AFFILIATE OF MUNSON DIALYSIS CENTER; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; CHANGE IN SCOPE OF SERVICES OR PROGRAMS PROVIDED BY MUNSON DIALYSIS CENTER; AND APPOINTMENT OF THE PRESIDENT. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE MUNSON DIALYSIS CENTER BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON DIALYSIS CENTER BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, PATIENT FINANCIAL SERVICES, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. THE COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE OVERSEES THE FORM 990 PREPARATION PROCESS BY ENSURING PROPER CONTROLS, POLICIES, PEOPLE AND RESOURCES ARE IN PLACE TO PRODUCE AN ACCURATE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE MUNSON HEALTHCARE BOARD OF DIRECTORS (THE SYSTEM PARENT ORGANIZATION) HAS A STANDING CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE. THE CVC COMMITTEE IS COMPOSED OF INDEPENDENT BOARD AND COMMUNITY MEMBERS. THE CVC COMMITTEE IS DELEGATED AUTHORITY BY THE BOARD TO REVIEW AND APPROVE THE REASONABLENESS/FAIR MARKET VALUE OF FINANCIAL TRANSACTIONS/ARRANGEMENTS WITH DISQUALIFIED PERSONS. ANNUALLY, EACH BOARD MEMBER OF MUNSON HEALTHCARE AND ALL OF ITS SUBSIDIARY/CONTROLLED ENTITIES AND ALL MUNSON EXECUTIVES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE/QUESTIONNAIRE. THE RESPONSES TO THE DISCLOSURE/QUESTIONNAIRE ARE REVIEWED BY THE MUNSON LEGAL DEPARTMENT. ANY FINANCIAL ARRANGEMENTS/POTENTIAL CONFLICTS IDENTIFIED THROUGH THE DISCLOSURE/QUESTIONNAIRES ARE PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND DETERMINATION AS TO THE REASONABLENESS/FAIR MARKET VALUE. WHEN AN ACTION ITEM IS CONSIDERED BY A BOARD WHICH INVOLVES A POTENTIAL CONFLICT BY A BOARD MEMBER, THE CONFLICT IS DISCLOSED AND A BOARD MEMBER WILL ABSTAIN FROM A VOTE ON THE ACTION ITEM, AND, IN ADDITION, THE BOARD CHAIR HAS THE DISCRETION/AUTHORITY TO REQUEST THAT THE CONFLICTED BOARD MEMBER BE EXCUSED FROM THE MEETING FOR AN OPPORTUNITY FOR THE BOARD TO DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE CONFLICTED BOARD MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. THE MUNSON HEALTHCARE CONFLICT, VALUATION AND COMPLIANCE ("CVC") COMMITTEE ALSO REVIEWS THE SURVEY INFORMATION TO EVALUATE THE REASONABLENESS OF EXECUTIVE COMPENSATION. THAT ANALYSIS OCCURS EACH NOVEMBER. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION OF OTHER OFFICERS IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES MUNSON DIALYSIS CENTER AND MUNSON HEALTHCARE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE MUNSON DIALYSIS CENTER ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON DIALYSIS CENTER DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES 316,149 251,739 0 |
| FORM 990, PART XI, LINE 9 | INTERCOMPANY TRANSFER TO PARENT -3,000,000 TOTAL -3,000,000 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd | Business Name Line2DisregardedEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MUNSON HEALTHCARE REGIONAL FOUNDATI | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382642724 | RAISE FUND | MI | C3 | 7 | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| MUNSON HOME CARE | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382191390 | HOME HEALT | MI | C3 | 9 | MUN HOME H | MUNSON HOME HEALTH | Yes (true) | ||
| MUNSON HOME HEALTH | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 383335362 | HOME HEALT | MI | C3 | 11B | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| MUNSON HOME SERVICES | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382543463 | HOME HEALT | MI | C3 | 9 | MUN HOME H | MUNSON HOME HEATLH | Yes (true) | ||
| MUNSON MEDICAL CENTER | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 381362830 | HOSPITAL | MI | C3 | 3 | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| NORTH FLIGHT INC | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382657917 | MED TRANSP | MI | C3 | 11B | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| PAUL OLIVER MEMORIAL HOSPITAL | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 381415623 | HEALTHCARE | MI | C3 | 3 | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| PAUL OLIVER MEMORIAL HOSPITAL FOUND | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 237201619 | RAISE FUND | MI | C3 | 7 | PAUL OL HO | PAUL OLIVER MEMORIAL HOSPITAL | Yes (true) | ||
| MUNSON HEALTHCARE | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 382640544 | PARENT | MI | C3 | 11B | false | N/A | |||
| MUNSON MEDICAL GROUP | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 273600575 | PHYSICIAN | MI | C3 | 9 | MUNSON MED | HEALTHCARE | Yes (true) | ||
| MUNSON HEALTHCARE CADILLAC | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 471156297 | HOSPITAL | MI | C3 | 3 | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| MUNSON HEALTHCARE GRAYLING | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 471161992 | HOSPITAL | MI | C3 | 3 | MUNSON HC | MUNSON HEALTHCARE | Yes (true) | ||
| MUNSON HEALTHCARE CADILLAC FOUNDATI | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 472857600 | RAISE FUND | MI | C3 | 7 | MHC CADILL | MUNSON HEALTHCARE CADILLAC | Yes (true) | ||
| MUNSON HEALTHCARE CHARLEVOIX HOSPIT | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 381459366 | HOSPITAL | MI | C3 | 3 | MUNSON HC | Yes (true) | |||
| MUNSON HEALTHCARE CHARLEVOIX | |||||||||||||
| 1105 SIXTH ST | TRAVERSE CITY | MI | 49684 | 753078034 | RAISE FUND | MI | C3 | 11A | MHC CHARLE | HOSPITAL | Yes (true) | HOSPITAL FOUNDATION | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| MUNSON MEDICAL BUILDING PARTNERS | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382830005 | REAL ESTAT | MI | N/A | false | false |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | |||||||||
| 2651 AERO PARK DR | TRAVERSE CITY | MI | 49686 | 383453378 | PURCHASING | MI | N/A | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line2RelatedOrganizationName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|
| MUNSON SUPPORT SERVICES | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382872821 | LAUNDRY | MI | N/A | Yes (true) | |
| MUNSON SERVICES INC | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 383144382 | PHARMACY | MI | N/A | Yes (true) | |
| MEDICAL OFFICE BUILDING CONDOMINIUM | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 383567278 | REAL ESTAT | MI | N/A | Yes (true) | ASSOCIATION |
| SIXTH STREET DRUGS INC | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382298290 | PHARMACY | MI | N/A | Yes (true) | |
| MEDICAL OFFICE CONDOMINIUM | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 201902620 | REAL ESTAT | MI | N/A | Yes (true) | ASSOCIATION |
| MUNSON MOBILE IMAGING INC | |||||||||
| PO BOX 1188 | TRAVERSE CITY | MI | 496851188 | 382704069 | IMAGING | MI | N/A | Yes (true) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MUNSON HEALTHCARE | ||
| M | $175,673 | ACTUAL AMOUNT PAID |
| MUNSON HEALTHCARE | ||
| P | $700,287 | ACTUAL AMOUNT PAID |
| MUNSON HEALTHCARE | ||
| Q | $389,320 | ACTUAL AMOUNT PAID |
| MUNSON HEALTHCARE | ||
| B | $3,000,000 | ACTUAL AMOUNT PAID |
| MUNSON MEDICAL CENTER | ||
| Q | $691,277 | ACTUAL AMOUNT PAID |
| MUNSON MEDICAL CENTER | ||
| S | $132,024 | ACTUAL AMOUNT PAID |
| MUNSON MEDICAL CENTER | ||
| P | $3,053,294 | ACTUAL AMOUNT PAID |
| MUNSON MEDICAL CENTER | ||
| O | $63,910 | ACTUAL AMOUNT PAID |
| NORTHERN MICHIGAN SUPPLY ALLIANCE | ||
| P | $455,672 | ACTUAL AMOUNT PAID |
| PAUL OLIVER MEMORIAL HOSPITAL | ||
| Q | $100,432 | LEASE CONTRACT PAYMENT |
| PAUL OLIVER MEMORIAL HOSPITAL | ||
| K | $65,982 | LEASE CONTRACT PAYMENT |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R | FormAndLineReferenceDesc |
| Explanation | MUNSON DIALYSIS CENTER USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES. ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED, SUMMARIZED, AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTS. | ExplanationTxt |
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