FURP.ORG / PUBLIC DATA EXPLORER

HOLLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
HOLLAND COMMUNITY HEALTH CENTER (EIN 20-0602574)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-07-22
IRS object ID
201512039349300511
Schema version
2014v5.0
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)
Return2015-07-22T09:32:30-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381337372PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BEENE GARTER LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line156 GRANDVILLE AVE SW SUITE 100AddressLine1Txt
CityGRAND RAPIDSCityNm
State AbbreviationMIStateAbbreviationCd
ZIP495034036ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200602574EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOLLAND COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOLLBusinessNameControlTxt
Phone6163943788PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1336 S RIVER AVEAddressLine1Txt
CityHOLLANDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP494233326ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDOUGLAS STERKENPersonNm
Person TitleBOARD MEMBERPersonTitleTxt
Phone6163943788PhoneNum
Signature2015-07-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARGARET W BISHOP CPAPreparerPersonNm
PTINP00295096PTIN
Phone6162355200PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDOUGLAS STERKENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1336 S RIVER AVEAddressLine1Txt
CityHOLLANDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP494233326ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,594,646GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionTO PROVIDE ACCESS TO QUALITY PRIMARY HEALTH CARE FOR ALL MEMBERS OF THE COMMUNITY WITH BOTH RESPECT AND COMPASSION.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers92TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$683,691PYContributionsGrantsAmt
CY Contributions Grants$588,759CYContributionsGrantsAmt
PY Program Service Revenue$827,934PYProgramServiceRevenueAmt
CY Program Service Revenue$1,005,887CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,511,625PYTotalRevenueAmt
CY Total Revenue$1,594,646CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,506,625PYOtherExpensesAmt
CY Other Expenses$1,599,646CYOtherExpensesAmt
PY Total Expenses$1,506,625PYTotalExpensesAmt
CY Total Expenses$1,599,646CYTotalExpensesAmt
PY Revenues Less Expenses$5,000PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,000CYRevenuesLessExpensesAmt
Total Assets BOY$260,164TotalAssetsBOYAmt
Total Assets EOY$349,386TotalAssetsEOYAmt
Total Liabilities BOY$255,164TotalLiabilitiesBOYAmt
Total Liabilities EOY$349,386TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,000NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
MissionTO IMPROVE THE HEALTH OF THE PATIENTS IN THE HOLLAND COMMUNITY BY PROVIDING QUALITY HEALTH CARE REGARDLESS OF LANGUAGE, FINANCIAL OR CULTURAL BARRIERS; THEREBY ASSURING THAT PRIMARY HEALTH CARE IS ACCESSIBLE TO ALL RESIDENTS OF THE AREA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,505,046ExpenseAmt
Revenue$1,005,887RevenueAmt
DescPROVIDED APPROXIMATELY 10,754 PATIENT HEALTH CARE VISITS.Desc
Total Program Service Expenses$1,505,046TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JIM JUNEWICKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6164866708PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1665 SEWARD AVE NW SUITE 340AddressLine1Txt
CityGRAND RAPIDSCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49504ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DALE SOWDERS
CHAIR1.00Yes (X)Yes (X)$0$0$0
DOUGLAS STERKEN
DIRECTOR1.00Yes (X)Yes (X)$0$0$0
SAMIR RAJANI MD
DIRECTOR1.00Yes (X)$0$0$0
JEAN MARTIN
DIRECTOR1.00Yes (X)$0$0$0
SUE FROST
TREASURER/SECRETARY40.00Yes (X)Yes (X)$0$71,713$0
ALLISON RUND MD
DIRECTOR1.00Yes (X)$0$0$0
JANE CLARK
DIRECTOR1.00Yes (X)$0$0$0
ELIZABETH ROLINSKI
FORMER DIRECTOR1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$71,713TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SPECTRUM HEALTH MEDICAL GROUPBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1665 SEWARD AVE NW SUITE 340AddressLine1Txt
CityGRAND RAPIDSCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49504ZIPCd
FieldValueIRS element (for citing)
ServicesSEE SCHEDULE OServicesDesc
Compensation$1,245,139CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$588,759RelatedOrganizationsAmt
Total Contributions$588,759TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT FEES621400$753,866$753,866
PHYSICIAN INCENTIVES621400$207,251$207,251
MEANINGFUL USE - MEDIC621400$44,770$44,770
FieldValueIRS element (for citing)
Total Program Service Revenue$1,005,887TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,594,646TotalRevenueColumnAmt
Related Or Exempt Func Income$1,005,887RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$75,000TotalAmt
Management And General$75,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$19,600TotalAmt
Management And General$19,600ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,170,139TotalAmt
Program Services$1,170,139ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$142,225TotalAmt
Program Services$142,225ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$72,871TotalAmt
Program Services$72,871ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,988TotalAmt
Program Services$1,988ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$14,858TotalAmt
Program Services$14,858ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$14,234TotalAmt
Program Services$14,234ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BAD DEBT EXPENSE$76,596$76,596
BANK SERVICE CHARGE$7,272$7,272
MISCELLANEOUS$3,368$3,368
OUTSIDE SERVICE$1,495$1,495

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,599,646TotalAmt
Program Services$1,505,046ProgramServicesAmt
Management And General$94,600ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$216,462BOYAmt
EOY$305,001EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$43,702BOYAmt
EOY$44,385EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$260,164BOYAmt
EOY$349,386EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$255,164BOYAmt
EOY$349,386EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$255,164BOYAmt
EOY$349,386EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$260,164BOYAmt
EOY$349,386EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$5,000ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,787,772TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$193,126DonatedServicesAndUseFcltsAmt
Revenue Not Reported$193,126RevenueNotReportedAmt
Revenue Subtotal$1,594,646RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,594,646TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,792,772TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$193,126DonatedServicesUseFcltsAmt
Expenses Not Reported$193,126ExpensesNotReportedAmt
Expenses Subtotal$1,599,646ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,599,646TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE INTERNAL REVENUE SERVICE HAS DETERMINED THE CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER PROVISIONS OF CODE SECTION 501(C)(3) WHEREBY ONLY UNRELATED BUSINESS INCOME, AS DEFINED BY SECTION 509(A)(1) OF THE CODE, IS SUBJECT TO FEDERAL INCOME TAX. THE CENTER CURRENTLY HAS NO UNRELATED BUSINESS ACTIVITY. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. IN ADDITION, THE CENTER QUILIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). TAX POSITIONS TAKEN ARE ASSESSED FOR UNCERTAINTY AND A PROVISION MAY BE RECORDED IF A TAX POSITION IS NOT LIKELY TO BE SUSTAINED UPON EXAMINATION. WITH LIMITED EXCEPTIONS, THE CENTER IS NO LONGER SUBJECT TO TAX AUDITS BY FEDERAL AUTHORITIES FOR YEARS PRIOR TO 2011.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
D STERKEN DR RAJANI DR RUND AN
EMPLOYEES OF SHMG AND BOARD MEMBERS/OFFICERS OF HCHC$1,509,387SHMG IS REIMBURSED FOR EXPENSES THEY PAY ON BEHALF OF HCHC.0
DALE SOWDERS
EMPLOYEE OF HOLLAND HOSPITAL AND BOARD MEMBER/OFFICER OF HCHC$70,659HH LEASES FACILITY TO HCHC0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITHIN THE GOVERNING BODY
FORM 990, PART VI, SECTION B, LINE 11DOUG STERKEN (BOARD MEMBER) REVIEWS THE FORM PRIOR TO FILING. THE COMPLETED AND FILED FORM 990 IS PRESENTED TO THE BOARD, HOWEVER, THERE IS NO REVIEW PROCESS BY THE ENTIRE BOARD OF DIRECTORS OF THE FORM 990 PRIOR TO IT'S FILING.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST
FORM 990, PART IX, LINE 11GPROVIDER AND CLINIC SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 1,170,139. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,170,139.
FORM 990 PART XII, LINE 2CTHERE IS NO FORMAL COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, HOWEVER, THE BOARD OF DIRECTORS SERVES THIS FUNCTION. THERE HAS BEEN NO CHANGE OF THIS PROCESS FROM THE PRIOR YEARS.
FORM 990, PART VII, SECTION A, LINE 1DOUGLAS SERKEN IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. DALE SOWDERS RECEIVES COMPENSATION FOR HIS WORK AT HOLLAND HOSPITAL, WHICH IS A FOUNDING MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. ALLISON RUND, M.D. RECEIVES COMPENSATION FOR HER WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HER TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. SAMIR RAJANI, M.D. IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. SUE FROST IS COMPENSATED BY SPECTRUM HEALTH MEDICAL GROUP FOR HER WORK AT HOLLAND COMMUNITY HEALTH CENTER. SPECTRUM HEALTH MEDICAL GROUP IS A RELATED ENTITY TO HOLLAND COMMUNITY HEALTH CENTER. SUE IS NOT COMPENSATED FOR HER TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 13-14HCHC DOES NOT HAVE A FORMAL WRITTEN WHISTLEBLOWER POLICY OR WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. THEY ADHERE TO THE POLICIES THAT HAVE BEEN SET FORTH BY SPECTRUM HEALTH MEDICAL GROUP.
FORM 990, PART VII, SECTION B, LINE 1(B)SPECTRUM HEALTH MEDICAL GROUP PAYS ALL OPERATING EXPENSES OF HCHC AND IS REIMBURSED BY HCHC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
HOLLAND COMMUNITY HOSPITALS
602 MICHIGAN AVENUEHOLLANDMI49423382800065HEALTH CARE NEEDS OF THE HOLLAND COMMUNITYMI501(C)(3)3N/A0
SPECTRUM HEALTH PRIMARY CARE PARTNERS DBA SPECTRUM HEALTH MEDICAL GROUP
665 SEWARD AVE NW SUITE 340GRAND RAPIDSMI49504381358164TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.MI501(C)(3)3N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SPECTRUM HEALTH MEDICAL GROUP
M$1,245,139COSTS PAID
SPECTRUM HEALTH MEDICAL GROUP
P$264,248COSTS PAID
HOLLAND COMMUNITY HOSPITAL
C$588,759PAYMENTS RECEIVED AND DUE
HOLLAND COMMUNITY HOSPITAL
K$70,659RENT PAID