COREWELL HEALTH: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- COREWELL HEALTH (EIN 38-2539929)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-07-29
- IRS object ID
- 201602119349300700
- Schema version
- 2014v6.0
- 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 | 2016-07-29T07:40:04-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 511 RENAISSANCE DR STE 120 | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382539929 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND HEALTH FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | BENTON HARBOR/ST JOSEPH | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 2699838300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVE | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY CALHOUN | PersonNm |
| Person Title | VP - FINANCE & CFO | PersonTitleTxt |
| Phone | 2699838300 | PhoneNum |
| Signature | 2016-07-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CAROL LALONDE CPA | PreparerPersonNm |
| PTIN | P00181637 | PTIN |
| Phone | 2699828000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID BURGHART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVE | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,189,796 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | LAKELANDHEALTH.ORG/LAKELAND-HEALTH-FOUNDATIONS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE AND ASSIST IN PROVIDING HEALTH CARE BY ACCEPTING CONTRIBUTIONS FOR LAKELAND REGIONAL HEALTH SYSTEM. | ActivityOrMissionDesc |
| Voting Members Governing Body | 32 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 30 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,570,378 | PYContributionsGrantsAmt |
| CY Contributions Grants | $820,634 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $522,247 | PYInvestmentIncomeAmt |
| CY Investment Income | $663,041 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,092,625 | PYTotalRevenueAmt |
| CY Total Revenue | $1,483,675 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $960,255 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,858,138 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $215,212 | PYOtherExpensesAmt |
| CY Other Expenses | $119,836 | CYOtherExpensesAmt |
| PY Total Expenses | $1,175,467 | PYTotalExpensesAmt |
| CY Total Expenses | $1,977,974 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,917,158 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$494,299 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,449,136 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,500,032 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $670,540 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $412,528 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,778,596 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,087,504 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ENHANCE HEALTH AND SERVE OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,757,337 | ExpenseAmt |
| Grant | $1,757,337 | GrantAmt |
| Desc | THE FOUNDATION DISTRIBUTED FUNDS TO A LOCAL AREA HOSPITAL FOR BETTER EQUIPMENT AND FACILITIES. THE FOUNDATION ALSO DISTRIBUTED FUNDS TO LOCAL NOT FOR PROFIT ENTITIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $100,801 | ExpenseAmt |
| Grant | $100,801 | GrantAmt |
| Desc | THE FOUNDATION DISTRIBUTED FUNDS TO 82 LOCAL HEALTH CARE STUDENTS FOR TUITION RELATED EXPENSES. THE FOUNDATION ALSO DISTRIBUTED FUNDS TO 11 ASSOCIATES IN NEED OF ASSISTANCE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,858,138 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 32 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 30 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STACY WAHLSTROM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2696871147 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3776 HOLLYWOOD RD | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| RANDY BETTICH | |||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICHARD DYER | |||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DANA WALES | |||||||
| SECRETARY/TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BILL HANLEY | |||||||
| PAST CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAVID BURGHART | |||||||
| DIRECTOR AND FOUNDATION PRESIDENT | 20.00 | 20.00 | Yes (X) | Yes (X) | $0 | $191,367 | $9,583 |
| LOREN HAMEL MD | |||||||
| DIRECTOR AND LAKELAND CEO | 1.00 | 54.00 | Yes (X) | Yes (X) | $0 | $820,557 | $17,922 |
| SANDI BOWMAN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LUCAS BROWN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RICHARD BUCKALEW | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES CLEVER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| WENDY EDWARDS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DAVE EIFLER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARC FLORIAN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KC GAST | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT GOTTLIEB | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BRITTANY GRASLEY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CAROLYN HANSON | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GYL KASEWURM | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHANE LIES | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KURT MARZKE | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BARBARA MEEKS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RANDALL MILLER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TIM PASSARO | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DON RADDE | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| EBON SANDERS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| STEPHEN SMITH | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KATHLEEN SNYDER | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CAROL STARKS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DENNIS SZYMANSKI MD | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DEB TOUHEY | |||||||
| DIRECTOR/AUXILIARY PRESIDENT | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KAY VARGA-SMITH | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARGE WIATROWSKI | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| EDWARD CONRAD | |||||||
| DIRECTOR (PART YEAR) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN PROSS MD | |||||||
| DIRECTOR (PART YEAR) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DIANA SEAMAN | |||||||
| DIRECTOR (PART YEAR) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TIMOTHY CALHOUN | |||||||
| VP - FINANCE & CFO | 1.00 | 49.00 | Yes (X) | $0 | $416,079 | $20,213 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,428,003 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $47,718 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $820,634 | AllOtherContributionsAmt |
| Total Contributions | $820,634 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $427,075 | TotalRevenueColumnAmt |
| Exclusion | $427,075 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $11,942,087 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $11,706,121 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $235,966 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $235,966 | TotalRevenueColumnAmt |
| Exclusion | $235,966 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,483,675 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $663,041 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,757,337 | TotalAmt |
| Program Services | $1,757,337 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,801 | TotalAmt |
| Program Services | $100,801 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,836 | TotalAmt |
| Management And General | $119,836 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,977,974 | TotalAmt |
| Program Services | $1,858,138 | ProgramServicesAmt |
| Management And General | $119,836 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,084,334 | BOYAmt |
| EOY | $730,283 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,414,055 | BOYAmt |
| EOY | $552,217 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,950,747 | BOYAmt |
| EOY | $14,784,874 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,432,658 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,449,136 | BOYAmt |
| EOY | $17,500,032 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $670,540 | BOYAmt |
| EOY | $412,528 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $670,540 | BOYAmt |
| EOY | $412,528 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,909,987 | BOYAmt |
| EOY | $4,390,380 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,169,909 | BOYAmt |
| EOY | $2,948,424 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,698,700 | BOYAmt |
| EOY | $9,748,700 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,778,596 | BOYAmt |
| EOY | $17,087,504 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,449,136 | BOYAmt |
| EOY | $17,500,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$494,299 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$266,912 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $70,119 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,345,122 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,561,310 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,737,959 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,570,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $820,634 | CurrentTaxYearAmt |
| Total | $20,035,403 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,345,122 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,561,310 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,737,959 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,570,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $820,634 | CurrentTaxYearAmt |
| Total | $20,035,403 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,416,415 | SubstantialContributorsTotAmt |
| Public Support Total170 | $18,618,988 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $119,160 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $96,864 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $96,554 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $248,976 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $427,075 | CurrentTaxYearAmt |
| Total | $988,629 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $47,199 | CurrentTaxYearMinus4YearsAmt |
| Total | $47,199 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,071,231 | TotalSupportAmt |
| Public Support CY170 | 0.88360 | PublicSupportCY170Pct |
| Public Support PY170 | 0.88630 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | SALE OF ASSETS - 2010 AMOUNT: $ 47,199. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,345,103 | BeginningYearBalanceAmt |
| Contributions | $97,628 | ContributionsAmt |
| Investment Earnings Or Losses | $291,404 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $765,330 | OtherExpendituresAmt |
| End Year Balance | $12,968,805 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,029,717 | BeginningYearBalanceAmt |
| Contributions | $12,033,910 | ContributionsAmt |
| Investment Earnings Or Losses | $312,388 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $30,912 | OtherExpendituresAmt |
| End Year Balance | $13,345,103 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $876,299 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $264,459 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $111,041 | OtherExpendituresAmt |
| End Year Balance | $1,029,717 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $854,341 | BeginningYearBalanceAmt |
| Contributions | $35,899 | ContributionsAmt |
| Investment Earnings Or Losses | $42,587 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $56,528 | OtherExpendituresAmt |
| End Year Balance | $876,299 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $821,475 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $92,383 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $59,517 | OtherExpendituresAmt |
| End Year Balance | $854,341 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.21830 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.75170 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COHEN & STEERS | Desc |
| Book Value | $1,432,658 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,432,658 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $197,240 |
| FUNDS HELD ON BEHALF OF OTHERS | $215,288 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $412,528 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,450,910 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$266,912 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $234,147 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | -$32,765 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,483,675 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,483,675 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,142,002 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $234,147 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | -$70,119 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $164,028 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,977,974 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,977,974 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO PROVIDE SCHOLARSHIPS FOR HEALTHCARE RELATED TO STUDY/WORK. |
| PART X, LINE 2: | THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS, THEREFORE, NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES. ACCORDINGLY, CONTRIBUTIONS TO THE FOUNDATION ARE DEDUCTIBLE BY THE DONOR FOR FEDERAL INCOME TAXES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE FOUNDATION TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. THE FOUNDATION HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2015 AND 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FOUNDATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2012. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | UNCOLLECTABLE PLEDGE RECOVERY -70,119. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1234 NAPIER AVENE | AddressLine1Txt |
| City | ST JOSEPH | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49085 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 382156872 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,757,337 | CashGrantAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | DISTRIBUTED FUNDS TO LOCAL HOSPITAL TO PROVIDE BETTER EQUIPMENT AND FACILITIES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|
| HEALTH CARE SCHOLARSHIPS | 82 | $95,996 | N/A | N/A |
| GRANTS TO ASSOCIATES IN NEED | 11 | $4,805 | N/A | N/A |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE SCHOLARSHIP GRANTS ARE MONITORED TO ENSURE THE STUDENT IS FURTHERING THEIR EDUCATION WITHIN THE HEALTHCARE INDUSTRY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID BURGHART | ||||||||||||||
| DIRECTOR AND FOUNDATION PRESIDENT | $0 | $171,598 | $0 | $8,232 | $0 | $11,537 | $0 | $7,010 | $0 | $2,573 | $0 | $200,950 | $0 | $0 |
| LOREN HAMEL MD | ||||||||||||||
| DIRECTOR AND LAKELAND CEO | $0 | $586,116 | $0 | $168,449 | $0 | $65,992 | $0 | $15,450 | $0 | $2,472 | $0 | $838,479 | $0 | $0 |
| TIMOTHY CALHOUN | ||||||||||||||
| VP - FINANCE & CFO | $0 | $333,440 | $0 | $57,986 | $0 | $24,653 | $0 | $15,450 | $0 | $4,763 | $0 | $436,292 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | LAKELAND MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE PLAN ARE: DAVID BURGHART; LOREN HAMEL, MD; TIMOTHY CALHOUN | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | THE FOUNDATION DISTRIBUTES FUNDS TO ASSOCIATES IN NEED OF ASSISTANCE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION IS ORGANIZED ON A STOCK BASIS. THE SOLE STOCKHOLDER OF THE ORGANIZATION IS LAKELAND REGIONAL HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE 990 HAS BEEN POSTED ON THE BOARD PORTAL FOR REVIEW PRIOR TO FILING. THE BOARD PORTAL IS AVAILABLE TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEO'S COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | UNCOLLECTABLE PLEDGE RECOVERY 70,119. |
| FORM 990, PART XII, LINE 2C: | THERE HAS BEEN NO CHANGE IN AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKELAND REGIONAL HEALTH SYSTEM INC | |||||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 382609624 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(C)(3) | LINE 11B, II | N/A | 0 | |
| LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | |||||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 382156872 | PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITY | MI | 501(C)(3) | LINE 3 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND SPECIALITY HOSPITAL AT BERRIEN CENTER | |||||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 383452303 | LONGTERM HEALTHCARE/HEALING SERVICES | MI | 501(C)(3) | LINE 3 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND HEALTH FOUNDATION NILES | |||||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 383130558 | PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGAN | MI | 501(C)(3) | LINE 7 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| MERCY MEMORIAL HEALTH SERVICES INC | |||||||||||
| 3425 LAKESHORE DRIVE | ST JOSEPH | MI | 49085 | 382748035 | PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN SOUTHWEST MICHIGAN | MI | 501(C)(3) | LINE 9 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| LAKELAND COMMUNITY HOSPITAL - WATERVLIET | |||||||||||
| 400 MEDICAL PARK DRIVE | WATERVLIET | MI | 49098 | 381368745 | TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCARE | MI | 501(C)(3) | LINE 9 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
| HOSPICE AT HOME INC | |||||||||||
| 4025 HEALTH PARK LANE | ST JOSEPH | MI | 49085 | 382416086 | TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILL | MI | 501(C)(3) | LINE 7 | Yes (1) | LAKELAND REGIONAL HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| VAN'S MEDICAL EQUIPMENT OF LAKELAND LLC | |||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 261497708 | MEDICAL EQUIPMENT | MI | N/A |
| CLIFFSIDE COMPANY LLC | |||||||
| 910 S WASHINGTON AVENUE | ROYAL OAK | MI | 48067 | 383306320 | ASSISTED LIVING | MI | N/A |
| LAKELINE ASSOCIATES LLC | |||||||
| 910 S WASHINGTON AVENUE | ROYAL OAK | MI | 48067 | 383306318 | PROPERTY MANAGEMENT/RENTAL | MI | N/A |
| LIBERTY DIALYSIS LAKELAND LLC | |||||||
| 7650 SE 27TH STREET SUITE 200 | MERCER ISLAND | WA | 98040 | 272099855 | MEDICAL SERVICES | WA | N/A |
| LDBH LLC | |||||||
| 7650 SE 27TH STREET SUITE 200 | MERCER ISLAND | WA | 98040 | 451745643 | MEDICAL SERVICES | WA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| LAKELAND HEALTH ENTERPRISES INC | |||||||||
| 31 NORTH ST JOSEPH AVENUE | NILES | MI | 49120 | 382669798 | ACCOUNTING AND BILLING | MI | N/A | C | Yes (1) |
| PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 382929090 | PHARMACEUTICALS | MI | N/A | C | Yes (1) |
| LAKELAND MEDICAL PRACTICES | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 270381199 | MEDICAL ADMINISTRATIVE SERVICES | MI | N/A | C | Yes (1) |
| SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 272589359 | PHYSICIAN OFFICE | MI | N/A | C | Yes (1) |
| FOUR FLAGS PROPERTIES INC | |||||||||
| 122 GRANT STREET | NILES | MI | 49120 | 364501639 | PROPERTY MANAGEMENT/RENTAL | MI | N/A | C | Yes (1) |
| LAKELAND HEALTH VENTURES INC | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 272313790 | HOLDING COMPANY | MI | N/A | C | Yes (1) |
| LAKELAND PHYSICIAN CARE NETWORK | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 208513031 | MEDICAL SERVICES | MI | N/A | C | Yes (1) |
| LAKELAND PERSONAL CARE SERVICES INC | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 272990797 | HEALTH CARE SERVICES | MI | N/A | C | Yes (1) |
| LAKELAND CARE INC | |||||||||
| 1234 NAPIER AVE | ST JOSEPH | MI | 49085 | 383225306 | CONTRACT NEGOTIATION | MI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | ||
| B | $1,757,337 | ACTUAL AMOUNTS GRANTED |
| LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC | ||
| O | $238,267 | ALLOCATION OF EXPENSE |
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