FURP.ORG / PUBLIC DATA EXPLORER

MOSES DIALYSIS UNIT: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MOSES DIALYSIS UNIT (EIN 32-0031170)
Tax period
2013-04-01 to 2014-03-31
Filed
2015-02-13
IRS object ID
201520449349301442
Schema version
2013v4.0
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)
Return2015-02-13T15:41:39-06:00ReturnTs
Tax Period End2014-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 12237AddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code543072237ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN320031170EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSES DIALYSIS UNITBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMOSEBusinessNameControlTxt
Phone9066438585PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11140 NORTH STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJASON ANDERSONPersonNm
Person TitleCFOPersonTitleTxt
Phone9066438585PhoneNum
Signature2015-02-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTERRI REXRODE CPA MSTPreparerPersonNm
PTINP00096513PTIN
Phone9206620016PhoneNum
Preparation2015-02-13PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJASON ANDERSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11140 NORTH STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$322,253GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MACKINACSTRAITSHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionTO PROVIDE EFFICIENT DELIVERY OF QUALITY DIALYSIS HEALTH CARE, ACHEIVE SUPERIOR PATIENT OUTCOMES AND IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITY WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$717,385PYProgramServiceRevenueAmt
CY Program Service Revenue$322,253CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$717,385PYTotalRevenueAmt
CY Total Revenue$322,253CYTotalRevenueAmt
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$320,627PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$267,627CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$168,383PYOtherExpensesAmt
CY Other Expenses$127,972CYOtherExpensesAmt
PY Total Expenses$489,010PYTotalExpensesAmt
CY Total Expenses$395,599CYTotalExpensesAmt
PY Revenues Less Expenses$228,375PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$73,346CYRevenuesLessExpensesAmt
Total Assets BOY$347,686TotalAssetsBOYAmt
Total Assets EOY$274,340TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$347,686NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$274,340NetAssetsOrFundBalancesEOYAmt
MissionNONEMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$395,599ExpenseAmt
Revenue$322,253RevenueAmt
Desc6MOSES DIALYSIS UNIT PROVIDES CARE AND TREATMENT TO INDIVIDUALS IN NEED OF RENAL DIALYSIS SERVICES IN THE GREATER ST. IGNACE, MI AREA.Desc
Total Program Service Expenses$395,599TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
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 AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 RequiredYes (1)ScheduleJRequiredInd
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 Ent0BusinessRlnWithOfficerEntInd
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 Members9GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JASON ANDERSONBusinessNameLine1
FieldValueIRS element (for citing)
Phone9066438585PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11140 NORTH STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
STEVE LUTZ
BOARD MEMBER1.00Yes (X)$0$0$0
BONNIE CULFA
BOARD MEMBER1.00Yes (X)$0$0$0
REV WAYNE FOOTE
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD SMITH
BOARD MEMBER1.00Yes (X)$0$0$0
BILL CONNOLLY
BOARD CHAIRPERSON1.00Yes (X)$0$0$0Yes (X)
ILENE MOSES
BOARD VICE CHAIRPERSON1.00Yes (X)$0$0$0Yes (X)
RODNEY NELSON
BOARD SECRETARY/TREASURER1.00Yes (X)$0$158,194$22,171Yes (X)40.00
GARY SHAW MD
BOARD MEMBER/CEO1.00Yes (X)$0$17,200$0Yes (X)4.00
JASON ANDERSON
BOARD MEMBER/CFO2.00Yes (X)$0$130,175$20,355Yes (X)40.00
NANCY NELSON
MANAGER40.00$59,466$0$804Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$59,466TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$305,569TotReportableCompRltdOrgAmt
Total Other Compensation$43,330TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MACKINAC STRAITS HEALTH SYSTEM INCBusinessNameLine1

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11140 NORTH STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode
FieldValueIRS element (for citing)
ServicesNURSING SERVICESServicesDesc
Compensation$267,627CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET DIALYSIS REVENUEDesc
Business621400BusinessCd
Total Revenue Column$322,253TotalRevenueColumnAmt
Related Or Exempt Func Income$322,253RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$322,253TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$322,253TotalRevenueColumnAmt
Related Or Exempt Func Income$322,253RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$60,270TotalAmt
Program Services$60,270ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$135,280TotalAmt
Program Services$135,280ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$18,977TotalAmt
Program Services$18,977ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$39,170TotalAmt
Program Services$39,170ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$13,930TotalAmt
Program Services$13,930ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$51,736TotalAmt
Program Services$51,736ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$97TotalAmt
Program Services$97ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,875TotalAmt
Program Services$4,875ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$70,296$70,296
OUTSIDE TRAINING$672$672
DUES & SUBSCRIPTIONS$110$110

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$186TotalAmt
Program Services$186ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$395,599TotalAmt
Program Services$395,599ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$213,923BOYAmt
EOY$139,183EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$133,763BOYAmt
EOY$135,157EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$347,686BOYAmt
EOY$274,340EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$347,686BOYAmt
EOY$274,340EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

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

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$347,686BOYAmt
EOY$274,340EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$347,686BOYAmt
EOY$274,340EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$73,346ReconcilationRevenueExpnssAmt
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)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationALTHOUGH MOSES DIALYSIS UNIT IS CLASSIFIED AS A HOSPITAL FOR SCHEDULE A PURPOSES, WE ARE NOT A LICENSED HOSPITAL AND, THEREFORE SCHEDULE H IS NOT REQUIRED.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM RELATED PARTYDesc
Book Value$135,157BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$135,157TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationIN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHINCAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF MARCH 31, 2014 OR 2013. THE ORGANIZATION'S TAX RETURNS FOR TAX YEARS 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RODNEY NELSON
BOARD SECRETARY/TREASURER$0$150,000$0$0$0$8,194$0$0$0$22,171$0$180,365$0$0
JASON ANDERSON
BOARD MEMBER/CFO$0$130,175$0$0$0$0$0$0$0$20,355$0$150,530$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS REVIEWED BY THE CEO OF MACKINAC STRAITS HEALTH SYSTEM, INC., WHICH CONTRACTS ALL EMPLOYEES OF MOSES DIALYSIS UNIT.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2RODNEY NELSON AND NANCY NELSON HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6MACKINAC STRAITS HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF MOSES DIALYSIS UNIT.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE CORPORATE MEMBER IS MACKINAC STRAITS HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION A, LINE 7BMOSES BOARD SUBJECT TO APPROVAL OF HOSPITAL BOARD.
FORM 990, PART VI, SECTION B, LINE 11THE BOARD OF DIRECTORS HAS DELEGATED THE REVIEW AND APPROVAL OF THE FORM 990 TO THE CFO. A COPY OF THE FORM 990 WILL BE PROVIDED TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12MOSES DIALYSIS UNIT DOES NOT HAVE ITS OWN CONFLICT OF INTEREST OR DOCUMENT RETENTION POLICIES. ALL PROFESSIONALS OF MOSES ARE CONTRACTED FROM MACKINAC STRAITS HEALTH SYSTEM, INC., THE COMPANY'S SOLE CORPORATE OWNER. CONTRACTED PROFESSIONALS ARE REQUIRED TO FOLLOW THE CONFLICT OF INTEREST AND DOCUMENT RETENTION POLICIES ENFORCED BY MACKINAC STRAITS HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION B, LINE 15ATHE PROCESS FOR DETERMINING ALL COMPENSATION IS BASED ON THE MHA ANNUAL SURVEY. COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS REVIEWED BY THE CEO OF MACKINAC STRAITS HEALTH SYSTEM, INC., WHICH CONTRACTS ALL EMPLOYEES OF MOSES DIALYSIS UNIT.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST ONLY.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 51,736. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,736.
FORM 990, PART XI, LINE 2CMOSES DIALYSIS UNIT IS INCLUDED IN THE CONSOLIDATED AUDIT OF MACKINAC STRAITS HEALTH SYSTEM, INC. AND AFFILIATE. THE AUDITED FINANCIAL STATEMENTS ARE PRESENTED TO THE MACKINAC STRAITS HEALTH SYSTEM FINANCE COMMITTEE AND RECOMMENDATIONS ARE TAKEN TO THE MACKINAC STRAITS HEALTH SYSTEM BOARD OF DIRECTORS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MACKINAC STRAITS HEALTH SYSTEM INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11140 NORTH STATE STREETAddressLine1
CityST IGNACECity
StateMIState
ZIP Code49781ZIPCode
FieldValueIRS element (for citing)
EIN208756459EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateMILegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
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 Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd