2015-07-22T09:32:30-05:00 2014-12-31 381337372 BEENE GARTER LLP 56 GRANDVILLE AVE SW SUITE 100 GRAND RAPIDS MI 495034036 990 2014-01-01 200602574 HOLLAND COMMUNITY HEALTH CENTER HOLL 6163943788 336 S RIVER AVE HOLLAND MI 494233326 DOUGLAS STERKEN BOARD MEMBER 6163943788 2015-07-13 1 MARGARET W BISHOP CPA P00295096 6162355200 2014 2016-02-25 16:41:14Z DOUGLAS STERKEN 336 S RIVER AVE HOLLAND MI 494233326 1594646 0 X N/A X 2004 MI TO PROVIDE ACCESS TO QUALITY PRIMARY HEALTH CARE FOR ALL MEMBERS OF THE COMMUNITY WITH BOTH RESPECT AND COMPASSION. 7 6 0 92 0 0 683691 588759 827934 1005887 0 0 0 0 1511625 1594646 0 0 0 0 0 0 0 0 0 1506625 1599646 1506625 1599646 5000 -5000 260164 349386 255164 349386 5000 0 TO 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. 0 0 1505046 1005887 PROVIDED APPROXIMATELY 10,754 PATIENT HEALTH CARE VISITS. 1505046 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 MI X JIM JUNEWICK 6164866708 665 SEWARD AVE NW SUITE 340 GRAND RAPIDS MI 49504 DALE SOWDERS CHAIR 1.00 X X 0 0 0 DOUGLAS STERKEN DIRECTOR 1.00 X X 0 0 0 SAMIR RAJANI MD DIRECTOR 1.00 X 0 0 0 JEAN MARTIN DIRECTOR 1.00 X 0 0 0 SUE FROST TREASURER/SECRETARY 40.00 X X 0 71713 0 ALLISON RUND MD DIRECTOR 1.00 X 0 0 0 JANE CLARK DIRECTOR 1.00 X 0 0 0 ELIZABETH ROLINSKI FORMER DIRECTOR 1.00 X 0 0 0 0 71713 0 0 0 0 0 SPECTRUM HEALTH MEDICAL GROUP 665 SEWARD AVE NW SUITE 340 GRAND RAPIDS MI 49504 SEE SCHEDULE O 1245139 1 588759 588759 PATIENT FEES 621400 753866 753866 PHYSICIAN INCENTIVES 621400 207251 207251 MEANINGFUL USE - MEDIC 621400 44770 44770 1005887 1594646 1005887 0 0 X 75000 75000 19600 19600 1170139 1170139 142225 142225 72871 72871 1988 1988 14858 14858 14234 14234 BAD DEBT EXPENSE 76596 76596 BANK SERVICE CHARGE 7272 7272 MISCELLANEOUS 3368 3368 OUTSIDE SERVICE 1495 1495 1599646 1505046 94600 0 216462 305001 43702 44385 260164 349386 255164 349386 255164 349386 X 5000 0 5000 0 260164 349386 -5000 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X 1787772 193126 193126 1594646 0 1594646 1792772 193126 193126 1599646 0 1599646 PART X, LINE 2: THE 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. D STERKEN DR RAJANI DR RUND AN EMPLOYEES OF SHMG AND BOARD MEMBERS/OFFICERS OF HCHC 1509387 SHMG IS REIMBURSED FOR EXPENSES THEY PAY ON BEHALF OF HCHC. 0 DALE SOWDERS EMPLOYEE OF HOLLAND HOSPITAL AND BOARD MEMBER/OFFICER OF HCHC 70659 HH LEASES FACILITY TO HCHC 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITHIN THE GOVERNING BODY FORM 990, PART VI, SECTION B, LINE 11 DOUG 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 19 AVAILABLE UPON REQUEST FORM 990, PART IX, LINE 11G PROVIDER 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 2C THERE 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 1 DOUGLAS 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 13-14 HCHC 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. HOLLAND COMMUNITY HOSPITALS 602 MICHIGAN AVENUE HOLLAND MI 49423 382800065 HEALTH CARE NEEDS OF THE HOLLAND COMMUNITY MI 501(C)(3) 3 N/A 0 SPECTRUM HEALTH PRIMARY CARE PARTNERS DBA SPECTRUM HEALTH MEDICAL GROUP 665 SEWARD AVE NW SUITE 340 GRAND RAPIDS MI 49504 381358164 TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. MI 501(C)(3) 3 N/A 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 SPECTRUM HEALTH MEDICAL GROUP M 1245139 COSTS PAID SPECTRUM HEALTH MEDICAL GROUP P 264248 COSTS PAID HOLLAND COMMUNITY HOSPITAL C 588759 PAYMENTS RECEIVED AND DUE HOLLAND COMMUNITY HOSPITAL K 70659 RENT PAID