COREWELL HEALTH: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COREWELL HEALTH (EIN 38-2539929)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-15
IRS object ID
201442279349302229
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-15T10:44:31-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1750 TRADE CENTRE WAY STE 300AddressLine1
CityPORTAGECity
StateMIState
ZIP Code49002ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382539929EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LAKELAND HEALTH FOUNDATIONBusinessNameLine1
Business Name Line2BENTON HARBOR/ST JOSEPHBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlLAKENameControl
Phone2699838300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11234 NAPIER AVENUEAddressLine1
CitySAINT JOSEPHCity
StateMIState
ZIP Code49085ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTIMOTHY CALHOUNName
TitleVP - FINANCE & CFOTitle
Phone2699838300Phone
Date Signed2014-08-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCAROL LALONDE CPAName
PTINP00181637PTIN
Phone2695674500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID BURGHARTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11234 NAPIER AVENUEAddressLine1
CitySAINT JOSEPHCity
StateMIState
ZIP Code49085ZIPCode
FieldValueIRS element (for citing)
Gross Receipts8352075GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other DescriptionFOUNDATIONTypeOfOrgOtherDescription
Year Formation1984YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO PROMOTE AND ASSIST IN PROVIDING HEALTH CARE BY ACCEPTING CONTRIBUTIONS FOR LAKELAND REGIONAL HEALTH SYSTEM.ActivityOrMissionDescription
Nbr Voting Members Governing Body31NbrVotingMembersGoverningBody
Nbr Independent Voting Members28NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers30TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2561310ContributionsGrantsPriorYear
Contributions Grants Current Year2737959ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year156539InvestmentIncomePriorYear
Investment Income Current Year196809InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2717849TotalRevenuePriorYear
Total Revenue Current Year2934768TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1788895GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY4733162GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year387906OtherExpensePriorYear
Other Expenses Current Year73707OtherExpensesCurrentYear
Total Expenses Prior Year2176801TotalExpensesPriorYear
Total Expenses Current Year4806869TotalExpensesCurrentYear
Revenues Less Expenses Prior Year541048RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1872101RevenuesLessExpensesCY
Total Assets BOY7371735TotalAssetsBOY
Total Assets EOY7284238TotalAssetsEOY
Total Liabilities BOY5800TotalLiabilitiesBOY
Total Liabilities EOY1507817TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7365935NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5776421NetAssetsOrFundBalancesEOY
Mission DescriptionPROMOTE AND ASSIST IN PROVIDING HEALTH CARE BY ACCEPTING CONTRIBUTIONS FOR LAKELAND REGIONAL HEALTH SYSTEM.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense4673225Expense
Grants4673225Grants
Revenue0Revenue
DescriptionTHE FOUNDATION DISTRIBUTED FUNDS TO A LOCAL AREA HOSPITAL FOR BETTER EQUIPMENT AND FACILITIES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense59937Expense
Grants59937Grants
Revenue0Revenue
DescriptionTHE FOUNDATION DISTRIBUTED FUNDS TO 35 LOCAL HEALTH CARE INDIVIDUALS FOR TUITION RELATED EXPENSES.Description
FieldValueIRS element (for citing)
Total Program Service Expense4733162TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members31NbrVotingGoverningBodyMembers
Number Independent Voting Members28NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1STACY WAHLSTROMBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2696871147TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11234 NAPIER AVEAddressLine1
CityST JOSEPHCity
StateMIState
ZIP Code49085ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
RICHARD DYER
CHAIRPERSON1.000.00XX000
BILL HANLEY
VICE CHAIRPERSON1.000.00XX000
RANDY BETTICH
SECRETARY/TREASURER1.000.00XX000
LOREN HAMEL MD
DIRECTOR AND LAKELAND CEO1.0054.00XX067119950637
DAVID BURGHART
DIRECTOR AND FOUNDATION PRESIDENT20.0020.00XX01621507727
SANDI BOWMAN
DIRECTOR1.000.00X000
LUCAS BROWN
DIRECTOR1.000.00X000
RICHARD BUCKALEW
DIRECTOR1.000.00X000
JAMES CLEVER
DIRECTOR1.000.00X000
EDWARD CONRAD
DIRECTOR1.000.00X000
WENDY EDWARDS
DIRECTOR1.000.00X000
MARC FLORIAN
DIRECTOR1.000.00X000
KC GAST
DIRECTOR1.000.00X000
ROBERT GOTTLIEB
DIRECTOR1.000.00X000
BRITTANY GRASLEY
DIRECTOR1.000.00X000
CAROLYN HANSON
DIRECTOR1.000.00X000
GYL KASEWURM
DIRECTOR1.000.00X000
KURT MARZKE
DIRECTOR1.000.00X000
BARBARA MEEKS
DIRECTOR1.000.00X000
RANDALL MILLER
DIRECTOR1.000.00X000
TIM PASSARO
DIRECTOR1.000.00X000
JOHN PROOS MD
DIRECTOR1.000.00X000
DON RADDE
DIRECTOR1.000.00X000
EBON SANDERS
DIRECTOR1.000.00X000
DIANA SEAMAN
DIRECTOR1.001.00X000
KATHLEEN SNYDER
DIRECTOR1.000.00X000
CAROL STARKS
DIRECTOR1.000.00X000
DENNIS SZYMANSKI MD
DIRECTOR1.0040.00X031362210395
KAY VARGA-SMITH
DIRECTOR1.002.00X000
DANA WALES
DIRECTOR1.000.00X000
MARGE WIATROWSKI
DIRECTOR1.000.00X000
TINA KIRBY
DIRECTOR (PART YEAR)1.000.00X000
PAT MOODY
DIRECTOR (PART YEAR)1.000.00X000
TIMOTHY CALHOUN
VP - FINANCE & CFO1.0049.00X036766236008
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1514633TotalReportableCompFrmRltdOrgs
Total Other Compensation104767TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations1000000RelatedOrganizations
All Other Contributions1737959AllOtherContributions
Total Contributions2737959TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column96554TotalRevenueColumn
Exclusion$96,554ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities5517562Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5417307Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities100255Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column100255TotalRevenueColumn
Exclusion$100,255ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2934768TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$196,809ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4673225Total
Program Services4673225ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total59937Total
Program Services59937ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total18000Total
Management And General18000ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total14900Total
Management And General14900ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total23212Total
Management And General23212ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2204Total
Management And General2204ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionUNCOLLECTABLE PLEDGESDescription
Total15391Total
Management And General15391ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4806869Total
Program Services4733162ProgramServices
Management And General73707ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY979742BOY
EOY420582EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2405405BOY
EOY2618019EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3986588BOY
EOY4245637EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7371735BOY
EOY7284238EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5800BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY1507817EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5800BOY
EOY1507817EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3314731BOY
EOY1878961EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3352504BOY
EOY3198760EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY698700BOY
EOY698700EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7365935BOY
EOY5776421EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7371735BOY
EOY7284238EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1872101ReconcilationRevenueExpenses
Reconciliation Unrealized Invest282587ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years392059CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2923180CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1345122CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2561310CurrentTaxYearMinus1Year
Current Tax Year2737959CurrentTaxYear
Total9959630Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years392059CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2923180CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1345122CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2561310CurrentTaxYearMinus1Year
Current Tax Year2737959CurrentTaxYear
Total9959630Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total3118540AmountsSubstContributorsTotal
Public Support Total1706841090PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years154774CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years145044CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years119160CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year96864CurrentTaxYearMinus1Year
Current Tax Year96554CurrentTaxYear
Total612396Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years47199CurrentTaxYearMinus2Years
Total47199Total
FieldValueIRS element (for citing)
Total Support10619225TotalSupport
Public Support Pertcentage1700.64420PublicSupportPertcentage170
Public Support Pertcent Prior Year0.61480PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SALE OF ASSETS - 2010 AMOUNT: $ 47,199.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance876299BeginningOfYearBalance
Investment Earnings Or Losses264459InvestmentEarningsOrLosses
Other Expenditures111041OtherExpenditures
End Of Year Balance1029717EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance854341BeginningOfYearBalance
Contributions35899Contributions
Investment Earnings Or Losses42587InvestmentEarningsOrLosses
Other Expenditures56528OtherExpenditures
End Of Year Balance876299EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance821475BeginningOfYearBalance
Investment Earnings Or Losses92383InvestmentEarningsOrLosses
Other Expenditures59517OtherExpenditures
End Of Year Balance854341EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2903675BeginningOfYearBalance
Contributions30080Contributions
Investment Earnings Or Losses48478InvestmentEarningsOrLosses
Other Expenditures2160758OtherExpenditures
End Of Year Balance821475EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3815278BeginningOfYearBalance
Contributions389004Contributions
Investment Earnings Or Losses3568InvestmentEarningsOrLosses
Other Expenditures1304175OtherExpenditures
End Of Year Balance2903675EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.01210BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.67850PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.30940TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RELATED PARTIESDescription
Amount$1,507,817Amount
FieldValueIRS element (for citing)
Total Of Amounts1507817TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt3410494TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments282587NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities193139DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990475726RevenueNotRptdF990
Revenue Subtotal2934768RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9902934768TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5000008TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities193139DonatedServicesUseOfFacilities
Expenses Not Rptd F990193139ExpensesNotRptdF990
Expenses Subtotal4806869ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9904806869TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TO PROVIDE SCHOLARSHIPS FOR HEALTHCARE RELATED TO STUDY/WORK.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS, THEREFORE, NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES. ACCORDINGLY, CONTRIBUTIONS TO THE FOUNDATION ARE DEDUCTIBLE BY THE DONOR FOR FEDERAL INCOME TAXES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE FOUNDATION TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. THE FOUNDATION HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FOUNDATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2010.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
1234 NAPIER AVENUEST JOSEPHMI49085382156872501(C)3391310N/AN/ADISTRIBUTED FUNDS TO LOCAL HOSPITAL TO PROVIDE BETTER EQUIPMENT AND FACILITIES
LAKELAND HEALTH FOUNDATION NILES
1234 NAPIER AVENUEST JOSEPHMI49085383130558501(C)310000N/AN/AGENERAL SUPPORT
HOSPICE AT HOME INC
4025 HEALTH PARK LANEST JOSEPHMI49085382416086501(C)33841656N/AN/ADISTRIBUTED FUNDS TO PROVIDE BETTER EQUIPMENT AND FACILITIES
BERRIEN REGIONAL EDUCATION SERVICE AGENCY
711 ST JOSEPH AVENUEBERRIEN SPRINGSMI49103381714920GOVERNMENTAL30000N/AN/AGENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
HEALTH CARE SCHOLARSHIPS3553748N/AN/A
GRANTS TO ASSOCIATES IN NEED146189N/AN/A

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE SCHOLARSHIP GRANTS ARE MONITORED TO ENSURE THE STUDENT IS FURTHERING THEIR EDUCATION WITHIN THE HEALTHCARE INDUSTRY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LOREN HAMEL MD
DIRECTOR AND LAKELAND CEO0511565010500005463404640204235072183600
DAVID BURGHART
DIRECTOR AND FOUNDATION PRESIDENT01580600720033700635401373016987700
DENNIS SZYMANSKI MD
DIRECTOR031362200000755002845032401700
TIMOTHY CALHOUN
VP - FINANCE & CFO02884080701030915103217003838040367000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationLAKELAND MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. THE INDIVIDUALS LISTED IN PART VII WHO PARTICIPATED IN THE PLAN ARE: LOREN HAMEL, MD; TIMOTHY CALHOUNExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 6THE CORPORATION IS ORGANIZED ON A STOCK BASIS. THE SOLE STOCKHOLDER OF THE ORGANIZATION IS LAKELAND REGIONAL HEALTH SYSTEM.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE 990 HAS BEEN POSTED ON THE BOARD PORTAL FOR REVIEW PRIOR TO FILING. THE BOARD PORTAL IS AVAILABLE TO ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12CTHE CORPORATE COMPLIANCE DEPARTMENT, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY, ANNUALLY DISTRIBUTES THE CONFLICT OF INTEREST DISCLOSURE SURVEY TO ALL CORPORATE AND SUBSIDIARY ORGANIZATION BOARD MEMBERS, EXECUTIVES AND OTHER LEADERSHIP EMPLOYEES. THE CORPORATE COMPLIANCE DEPARTMENT, THROUGH THE GOVERNANCE COMMITTEE, COMPILES AND ANALYZES SURVEY DATA BY ORGANIZATION, INVESTIGATES, AND REVIEWS POTENTIAL CONFLICTS WITH THE ORGANIZATION'S CEO AND BOARD CHAIR, AND WHEN NECESSARY, RECOMMENDS ACTIONS TO BE TAKEN TO RESOLVE IDENTIFIED CONFLICTS. A COMPLETE REPORT OF ALL CORPORATE AND SUBSIDIARY BOARD MEMBER AND EXECUTIVE DISCLOSURES, CONFLICTS IDENTIFIED AND ACTIONS TAKEN IS REVIEWED BY THE GOVERNANCE COMMITTEE AND EACH SUBSIDIARY CEO AND BOARD CHAIR RECEIVES A REPORT SPECIFIC TO THEIR ORGANIZATION'S BOARD MEMBERS AND EXECUTIVES. BOARD MEMBERS FAILING TO COMPLETE A DISCLOSURE SURVEY OR INTENTIONALLY FAILING TO REPORT A KNOWN CONFLICT OF INTEREST ARE ASKED TO RESIGN.
THE CEO AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. AN INDEPENDENT FIRM IS HIRED BY THE BOARD TO DETERMINE COMPENSATION PACKAGES FOR THE CEO AND SENIOR MANAGEMENT ON AN ANNUAL BASIS. THE FIRM PRESENTS COMPARATIVE PAY RANGES AND COMPENSATION RECOMMENDATIONS TO THE GOVERNANCE (COMPENSATION) COMMITTEE FOR THEIR APPROVAL. FOR SENIOR MANAGEMENT, THE CEO CAN PROVIDE INPUT AND RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. FOR THE CEO'S COMPENSATION, THE GOVERNANCE COMMITTEE PRESENTS THE COMPENSATION PACKAGE TO THE FULL BOARD FOR APPROVAL. WRITTEN CONTRACTS FOR THE CEO ARE APPROVED BY THE FULL BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS FISCAL YEAR 2013.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THERE HAS BEEN NO CHANGE IN AUDIT OVERSIGHT PROCESS FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
LAKELAND REGIONAL HEALTH SYSTEM INC
1234 NAPIER AVENUEST JOSEPHMI49085382609624PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITYMI501(C)(3)LINE 11B, IIN/A0
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
1234 NAPIER AVENUEST JOSEPHMI49085382156872PROVIDE A COMPREHENSIVE SYSTEM OF HEALTH CARE TO CITIZENS OF THE COMMUNITYMI501(C)(3)LINE 31LAKELAND REGIONAL HEALTH SYSTEM INC
LAKELAND SPECIALITY HOSPITAL AT BERRIEN CENTER
1234 NAPIER AVENUEST JOSEPHMI49085383452303LONGTERM HEALTHCARE/HEALING SERVICESMI501(C)(3)LINE 31LAKELAND REGIONAL HEALTH SYSTEM INC
LAKELAND HEALTH FOUNDATION NILES
1234 NAPIER AVENUEST JOSEPHMI49085383130558PROMOTE/ASSIST IN PROVIDING HEALTH CARE SERVICES IN SOUTHWESTERN MICHIGANMI501(C)(3)LINE 71LAKELAND REGIONAL HEALTH SYSTEM INC
MERCY MEMORIAL HEALTH SERVICES INC
3425 LAKESHORE DRIVEST JOSEPHMI49085382748035PROVIDE HOMECARE AND LONG-TERM HEALTHCARE TO PATIENTS IN SOUTHWEST MICHIGANMI501(C)(3)LINE 91LAKELAND REGIONAL HEALTH SYSTEM INC
LAKELAND COMMUNITY HOSPITAL - WATERVLIET
400 MEDICAL PARK DRIVEWATERVLIETMI49098381368745TO PROVIDE GENERAL HEALTH OF THE COMMUNITY THROUGH EDUCATION AND HEALTHCAREMI501(C)(3)LINE 91LAKELAND REGIONAL HEALTH SYSTEM INC
HOSPICE AT HOME INC
4025 HEALTH PARK LANEST JOSEPHMI49085382416086TO PROVIDE HOSPICE AND PALLIATIVE CARE TO THE TERMINALLY ILLMI501(C)(3)LINE 71LAKELAND REGIONAL HEALTH SYSTEM INC

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
VAN'S MEDICAL EQUIPMENT OF LAKELAND LLC
1234 NAPIER AVENUEST JOSEPHMI49085261497708MEDICAL EQUIPMENTMIN/A
CLIFFSIDE COMPANY LLC
910 S WASHINGTON AVENUEROYAL OAKMI48067383306320ASSISTED LIVINGMIN/A
LAKELINE ASSOCIATES LLC
910 S WASHINGTON AVENUEROYAL OAKMI48067383306318PROPERTY MANAGEMENT/RENTALMIN/A
LIBERTY DIALYSIS LAKELAND LLC
7650 SE 27TH STREET SUITE 200MERCER ISLANDWA98040272099855MEDICAL SERVICESWAN/A
LDBH LLC
7650 SE 27TH STREET SUITE 200MERCER ISLANDWA98040451745643MEDICAL SERVICESWAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
LAKELAND HEALTH ENTERPRISES INC
31 NORTH ST JOSEPH AVENUENILESMI49120382669798ACCOUNTING AND BILLINGMILAKELAND REGIONAL HEALTH SYSTEMC1
PHARMACY SHOPPE INC DBA LAKELAND PHARMACY SHOPPE INC
1234 NAPIER AVENUEST JOSEPHMI49085382929090PHARMACEUTICALSMILAKELAND HEALTH ENTERPRISESC1
LAKELAND MEDICAL PRACTICES
1234 NAPIER AVENUEST JOSEPHMI49085270381199MEDICAL ADMINISTRATIVE SERVICESMILAKELAND HEALTH ENTERPRISESC1
SOUTHWESTERN MEDICAL CLINIC PHYSICIANS INC
1234 NAPIER AVENUEST JOSEPHMI49085272589359PHYSICIAN OFFICEMILAKELAND HEALTH ENTERPRISESC1
FOUR FLAGS PROPERTIES INC
122 GRANT STREETNILESMI49120364501639PROPERTY MANAGEMENT/RENTALMILAKELAND HEALTH ENTERPRISESC1
LAKELAND HEALTH VENTURES INC
1234 NAPIER AVENUEST JOSEPHMI49085272313790HOLDING COMPANYMILAKELAND HEALTH ENTERPRISESC1
LAKELAND PHYSICIAN CARE NETWORK
1234 NAPIER AVENUEST JOSEPHMI49085208513031MEDICAL SERVICESMILAKELAND HEALTH ENTERPRISESC1
LAKELAND PERSONAL CARE SERVICES INC
1234 NAPIER AVENUEST JOSEPHMI49085272990797HEALTH CARE SERVICESMILAKELAND HEALTH ENTERPRISESC1
LAKELAND CARE INC
1234 NAPIER AVENUEST JOSEPHMI49085383225306CONTRACT NEGOTIATIONMIC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
B391310ACTUAL AMOUNTS GRANTED
HOSPICE AT HOME INC
B3841656ACTUAL AMOUNTS GRANTED
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
C1000000ACTUAL AMOUNTS CONTRIBUTED
LAKELAND HOSPITALS AT NILES AND ST JOSEPH INC
O193139ALLOCATION OF EXPENSE

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