COPPER SHORES COMMUNITY HEALTH FOUNDATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COPPER SHORES COMMUNITY HEALTH FOUNDATION (EIN 38-3022945)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-13
- IRS object ID
- 201441339349301259
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-13T08:51:05-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 E FRONT ST SUITE 300 | AddressLine1 |
| City | TRAVERSE CITY | City |
| State | MI | State |
| ZIP Code | 49686 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383022945 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTAGE HEALTH FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PORT | NameControl |
| Phone | 9064878000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 QUINCY STREET PO BOX 299 | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEVIN STORE | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 9064878000 | Phone |
| Date Signed | 2014-04-22 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00181637 | PTIN |
| Phone | 2319477800 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | JAMES BOGAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 QUINCY STREET PO BOX 299 | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1112181 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PORTAGEHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX-EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 12 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 57648 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 53243 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 74718 | InvestmentIncomePriorYear |
| Investment Income Current Year | 98887 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -2062 | OtherRevenuePriorYear |
| Other Revenue Current Year | -5008 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 130304 | TotalRevenuePriorYear |
| Total Revenue Current Year | 147122 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 31690 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 39440 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10326 | OtherExpensePriorYear |
| Other Expenses Current Year | 10819 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 42016 | TotalExpensesPriorYear |
| Total Expenses Current Year | 50259 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 88288 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 96863 | RevenuesLessExpensesCY |
| Total Assets BOY | 1891937 | TotalAssetsBOY |
| Total Assets EOY | 2076610 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1891937 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2076610 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 37990 | Expense |
| Grants | 37990 | Grants |
| Description | PROMOTION OF CHARITABLE MISSION OF RELATED TAX-EXEMPT HEALTHCARE ENTITY | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1200 | Expense |
| Grants | 1200 | Grants |
| Description | GAS CARDS FOR TRAVELING RADIATION PATIENTS | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 250 | Expense |
| Grants | 250 | Grants |
| Description | OUTSTANDING NURSING AWARD | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 39440 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN BINKLEY CFO (SEE SCHEDULE O FOR ADDL INFO) | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9064831503 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 CAMPUS DRIVE | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| PAUL OLLILA | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| NANCY FENTON | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| TERRY KINZEL MD | |||||||
| DIRECTOR | 0.50 | 24.00 | X | 0 | 135550 | 11006 | |
| JEANNE KURTZ | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| LENNON MATTILA HUGHES | |||||||
| CHAIR | 1.00 | 0.00 | X | 0 | 0 | 0 | X |
| JAMES BOGAN | |||||||
| DIRECTOR, HOSPITAL CEO | 0.50 | 40.00 | X | 0 | 345968 | 30690 | X |
| WILLIAM POLKINGHORNE | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| ROGER HELMAN JD CFP | |||||||
| VICE CHAIR | 1.00 | 0.00 | X | 0 | 0 | 0 | X |
| DANA JOHNSON PHD | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| MICHELE BLAU | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| BRENT PETERSON | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| BERNADETTE YEOLMAN-OUELLETTE | |||||||
| SECRETARY/TREASURER | 1.00 | 0.00 | X | 0 | 0 | 0 | X |
| JEFFRY DENNIS | |||||||
| DIRECTOR | 0.50 | 0.00 | X | 0 | 0 | 0 | |
| BRIAN DONAHUE | |||||||
| VP FINANCE AND CFO | 0.50 | 40.00 | 0 | 178963 | 27706 | X | |
| KEVIN STORE | |||||||
| EXECUTIVE DIRECTOR | 0.50 | 40.00 | 0 | 150760 | 20741 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 811241 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 90143 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 37066 | FundraisingEvents |
| All Other Contributions | 16177 | AllOtherContributions |
| Total Contributions | 53243 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54653 | TotalRevenueColumn |
| Exclusion | $54,653 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 996008 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 951774 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 44234 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 44234 | TotalRevenueColumn |
| Exclusion | $44,234 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 8277 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 37066 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 13285 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -5008 | TotalRevenueColumn |
| Exclusion | -$5,008 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 147122 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $93,879 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37990 | Total |
| Program Services | 37990 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1450 | Total |
| Program Services | 1450 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10819 | Total |
| Management And General | 10819 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50259 | Total |
| Program Services | 39440 | ProgramServices |
| Management And General | 10819 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49728 | BOY |
| EOY | 57176 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 549306 | BOY |
| EOY | 791893 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18615 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18615 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1276884 | BOY |
| EOY | 1209824 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16019 | BOY |
| EOY | 17717 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1891937 | BOY |
| EOY | 2076610 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1891937 | BOY |
| EOY | 2076610 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1891937 | BOY |
| EOY | 2076610 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1891937 | BOY |
| EOY | 2076610 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 96863 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 87810 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTAGE HEALTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381381288 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $37,990 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 37990 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1842209 | BeginningOfYearBalance |
| Contributions | 1570 | Contributions |
| Investment Earnings Or Losses | 186682 | InvestmentEarningsOrLosses |
| Administrative Expenses | 11028 | AdministrativeExpenses |
| End Of Year Balance | 2019433 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1773348 | BeginningOfYearBalance |
| Contributions | 31535 | Contributions |
| Investment Earnings Or Losses | 47838 | InvestmentEarningsOrLosses |
| Administrative Expenses | 10513 | AdministrativeExpenses |
| End Of Year Balance | 1842209 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1557595 | BeginningOfYearBalance |
| Contributions | 20390 | Contributions |
| Investment Earnings Or Losses | 205536 | InvestmentEarningsOrLosses |
| Administrative Expenses | 10173 | AdministrativeExpenses |
| End Of Year Balance | 1773348 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1501685 | BeginningOfYearBalance |
| Contributions | 27263 | Contributions |
| Investment Earnings Or Losses | 38238 | InvestmentEarningsOrLosses |
| Administrative Expenses | 9591 | AdministrativeExpenses |
| End Of Year Balance | 1557595 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1672098 | BeginningOfYearBalance |
| Contributions | 21989 | Contributions |
| Investment Earnings Or Losses | -183299 | InvestmentEarningsOrLosses |
| Administrative Expenses | 9103 | AdministrativeExpenses |
| End Of Year Balance | 1501685 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.99100 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00900 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18615 | OtherCostOrOtherBasis |
| Depreciation | 18615 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENT FUNDS ARE TO BE USED FOR GRANTING WITHIN PORTAGE HEALTH, INC. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | NOTES TO CONSOLIDATED FINANCIAL STATEMENTS: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SPRING BALL | NameOfEvent1 |
| Gross Receipts Event1 | 29528 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 22315 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 7213 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 2400 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 4000 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 3531 | OtherDirectExpensesEvent1 |
| Name Of Event2 | AUCTION | NameOfEvent2 |
| Gross Receipts Event2 | 14690 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 14306 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 384 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 1548 | NonCashPrizesEvent2 |
| Other Direct Expenses Event2 | 50 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 1125 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 445 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 680 | GrossRevenueOtherEvents |
| Entertainment Other Events | 500 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 1256 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 45343 | GrossReceiptsTotal |
| Charitable Contributions Total | 37066 | CharitableContributionsTotal |
| Gross Revenue Total Events | 8277 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 1548 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 2400 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 4000 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 500 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 4837 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 13285 | DirectExpenseSummaryEvents |
| Net Income Summary | -5008 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|---|
| PORTAGE HEALTH INC | |||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 7990 | N/A | N/A | NAMASTE CARE EQUIPMENT |
| PORTAGE HEALTH INC | |||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 30000 | N/A | N/A | WELLNESS INITIATIVE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE ORGANIZATION REQUESTS A PROGRAM OVERVIEW AND BUDGET, A 6 MONTH PROGRESS REPORT, AND A FINAL STATUS REPORT COMPLETED WITHIN 60 DAYS FROM THE FINAL EXPENDITURES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES BOGAN | ||||||||||||||
| DIRECTOR, HOSPITAL CEO | 0 | 286165 | 0 | 51990 | 0 | 7813 | 0 | 14813 | 0 | 15877 | 0 | 376658 | 0 | 0 |
| BRIAN DONAHUE | ||||||||||||||
| VP FINANCE AND CFO | 0 | 158076 | 0 | 19733 | 0 | 1154 | 0 | 12873 | 0 | 14833 | 0 | 206669 | 0 | 0 |
| KEVIN STORE | ||||||||||||||
| EXECUTIVE DIRECTOR | 0 | 77378 | 0 | 70652 | 0 | 2730 | 0 | 9149 | 0 | 11592 | 0 | 171501 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | SCHEDULE J, PART I, LINE 3: THE FOLLOWING INDIVIDUALS, LISTED AS TOP MANAGEMENT OFFICIALS OF THE FOUNDATION, ARE COMPENSATED BY RELATED ORGANIZATION PORTAGE HEALTH, INC.: JAMES BOGAN, FOUNDATION DIRECTOR AND HOSPITAL PRESIDENT AND CEO KEVIN STORE, EXECUTIVE DIRECTOR PORTAGE HEALTH, INC. UTILIZES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANTS, WRITTEN EMPLOYEMENT CONTRACTS, COMPENSATION SURVEY OR STUDIES, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THEIR COMPENSATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION AND RE-ELECTION OF ALL MEMBERS OF THE FOUNDATION BOARD OF DIRECTORS SHALL BE, INDIVIDUALLY OR COLLECTIVELY, BY AFFIRMATIVE ACTION OF THE BOARD OF DIRECTORS OF PORTAGE HEALTH. THE FOUNDATION BOARD SHALL NOMINATE CANDIDATES FOR ELECTION OR RE-ELECTION AS DIRECTORS BY RESOLUTION AND SUBMIT SUCH NOMINATIONS TO THE PORTAGE HEALTH BOARD OF DIRECTORS FOR RATIFICATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF DIRECTORS OF THE FOUNDATION MAY PROPOSE AMENDMENTS TO THE BOARD BYLAWS, WHICH MUST BE THEN SUBMITTED FOR APPROVAL BY THE BOARD OF DIRECTORS OF PORTAGE HEALTH. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE EXECUTIVE DIRECTOR OF THE FOUNDATION REVIEWS THE FORM 990 IN DETAIL PRIOR TO FILING. THE 990 IS THEN REVIEWED WITH FOUNDATION BOARD MEMBERS AT A REGULARLY SCHEDULED BOARD MEETING. EACH BOARD MEMBER IS PROVIDED A COPY OF THE FORM 990 FOR REVIEW BEFORE THE RETURN HAS BEEN FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | AN ANNUAL CONFLICT OF INTEREST STATEMENT IS COMPLETED AND SIGNED BY EACH BOARD MEMBER. THE PRESIDENT AND CEO REVIEWS THE COMPLETED CONFLICT OF INTEREST FORMS. IF A CONFLICT IS IDENTIFIED, THAT BOARD MEMBER IS EXCUSED FROM ANY DICUSSION OR VOTE RELATING TO THE IDENTIFIED CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS UTILIZED AN OUTSIDE CONSULTANT TO RESEARCH AND PRESENT MARKET DATA FOR THE PURPOSES OF DETERMINING AND ADJUSTING, AS NECESSARY, THE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE MOST RECENT MARKET SURVEY WAS CONDUCTED IN NOVEMBER 2011 AND IS ANTICIPATED TO BE CONDUCTED AND REVIEWED AGAIN IN NOVEMBER 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2B: | THE FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTANT ON A CONSOLIDATED BASIS. |
| FORM 990, PART XII, LINE 2C: | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| FORM 990, PART VI, SECTION B, LINES 13 AND 14: | THE FOUNDATION DOES NOT HAVE WRITTEN WHISTLEBLOWER OR DOCUMENT RETENTION AND DESTRUCTION POLICIES. THE FOUNDATION WOULD DEFER TO THE POLICIES OF PORTAGE HEALTH, INC. IN THESE CIRCUMSTANCES. |
| FORM 990, PART VI, SECTION C, LINE 20: | INDIVIDUALS WHO POSSESS THE BOOKS AND RECORDS OF THE ORGANIZATION: SUSAN BINKLEY, CFO PORTAGE HEALTH, INC. 500 CAMPUS DRIVE HANCOCK, MI 49930 (906) 483-1503 KEVIN STORE, EXECUTIVE DIRECTOR PORTAGE HEALTH FOUNDATION 400 QUINCY STREET, PO BOX 299 HANCOCK, MI 49930 (906) 523-5920 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PORTAGE HEALTH INC | |||||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | IMPROVING HEALTH OF COMMUNITY BY PROVIDING HIGH QUALITY HEALTHCARE SERVICES | MI | 501(C)3 | LINE 3 | N/A | 0 | |
| PORTAGE HEALTH RESOURCES INC | |||||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 383041729 | SENIOR MEALS | MI | 501(C)3 | LINE 11A, I | 1 | PORTAGE HEALTH INC | |
| PORTAGE HEALTH HOME SERVICES INC | |||||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 383565553 | PRIVATE DUTY CARE | MI | 501(C)3 | LINE 9 | 1 | PORTAGE HEALTH INC | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COPPER COUNTRY APOTHECARIES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 CAMPUS DRIVE | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 302083778 | EIN |
| Primary Activity | RETAIL PHARMACY | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |