THUNDER BAY COMMUNITY HEALTH SERVICE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- THUNDER BAY COMMUNITY HEALTH SERVICE INC (EIN 38-2290337)
- Tax period
- 2012-03-01 to 2013-02-28
- Filed
- 2013-09-03
- IRS object ID
- 201312469349300311
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-09-03T09:27:23-05:00 | Timestamp |
| Tax Period End Date | 2013-02-28 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YEO & YEO PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3275 | AddressLine1 |
| City | SAGINAW | City |
| State | MI | State |
| ZIP Code | 48605 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-03-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382290337 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THUNDER BAY COMMUNITY HEALTH | BusinessNameLine1 |
| Business Name Line2 | SERVICE | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | THUN | NameControl |
| Phone | 9897424583 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15774 STATE STREET PO BOX 427 | AddressLine1 |
| City | HILLMAN | City |
| State | MI | State |
| ZIP Code | 49746 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHELLE STYMA | Name |
| Title | CEO | Title |
| Phone | 9897424583 | Phone |
| Date Signed | 2013-08-25 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN R DIXON | Name |
| Phone | 9897939830 | Phone |
| Date Prepared | 2013-08-25 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHELLE STYMA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15774 STATE STREET PO BOX 427 | AddressLine1 |
| City | HILLMAN | City |
| State | MI | State |
| ZIP Code | 49746 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12651593 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.TBCHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS ITS RESOURCES AND PASSION TO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICES FOR PEOPLE OF ALL AGES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 135 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 4536057 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4209888 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4452007 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4480139 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8698 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4381 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3146690 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2703661 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12143452 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11398069 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 82500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 82500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6353387 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5985605 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5233061 | OtherExpensePriorYear |
| Other Expenses Current Year | 4663483 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11668948 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10731588 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 474504 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 666481 | RevenuesLessExpensesCY |
| Total Assets BOY | 7615030 | TotalAssetsBOY |
| Total Assets EOY | 8159634 | TotalAssetsEOY |
| Total Liabilities BOY | 3427426 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3277549 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4187604 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4882085 | NetAssetsOrFundBalancesEOY |
| Mission Description | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS ITS RESOURCES AND PASSION TO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICES FOR PEOPLE OF ALL AGES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 7670732 | Expense |
| Grants | 82500 | Grants |
| Description | THE ORGANIZATION PROVIDED PRIMARY MEDICAL, DENTAL, BEHAVIORAL HEALTH, LAB AND X-RAY SERVICES TO MEDICALLY UNDERSERVED REGARDLESS OF THE PATIENTS' ABILITY TO PAY. | Description |
| Total Program Service Expense | 7670732 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 15 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 135 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LEIGHANN MILL | NamePerson |
| Telephone Number | 9893542197 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N RIPLEY SUITE E | AddressLine1 |
| City | ALPENA | City |
| State | MI | State |
| ZIP Code | 49707 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| MIKE WURTSMITH | |||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| NANCY DEXTROM | |||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| TARRY DEO | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ROD FULLERTON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| BEN BOLSER | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| AL MOE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| NINA KENNARD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| SHANNA JOHNSON | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | ||
| BEACH HALL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ELEANOR LUTZE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MARY FITZGERALD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JACQUELYN MCINTIRE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MARION HAUTEA | |||||||
| CMO | 40.00 | 224435 | 0 | 18791 | X | ||
| MICHELLE STYMA | |||||||
| CEO | 40.00 | 159054 | 0 | 16802 | X | ||
| SHARRON GALLOP | |||||||
| CFO | 18.00 | 69388 | 0 | 4526 | X | ||
| ANTHONY VANHORN | |||||||
| CIO | 40.00 | 66575 | 0 | 12953 | X | ||
| JEMELLEE JACALA-TADIAN | |||||||
| PHYSICIAN | 40.00 | 180500 | 0 | 17592 | X | ||
| TIMOTHY HAYES | |||||||
| PHYSICIAN | 40.00 | 160500 | 0 | 10513 | X | ||
| AMY KANE | |||||||
| NURSE PRACTI | 40.00 | 128978 | 0 | 15756 | X | ||
| TIA JEFFERS | |||||||
| DENTIST | 40.00 | 125663 | 0 | 9349 | X | ||
| WAYNE MCEWEN | |||||||
| PHYSICIANS A | 40.00 | 120203 | 0 | 15456 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1235296 | TotalReportableCompFromOrg |
| Total Other Compensation | 121738 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BRUCE DIETZ | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 S STATE | AddressLine1 |
| City | ALPENA | City |
| State | MI | State |
| ZIP Code | 49707 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | CONTRACT/LOANS | DescriptionOfServices |
| Compensation | 123591 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Government Grants | 2152332 | GovernmentGrants |
| All Other Contributions | 2057556 | AllOtherContributions |
| Noncash Contributions | 2047330 | NoncashContributions |
| Total Contributions | 4209888 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT FEES | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 4480139 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4480139 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4480139 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4381 | TotalRevenueColumn |
| Exclusion | $4,381 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 35012 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23895 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 11117 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11117 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11117 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 3760216 | GrossSalesOfInventory |
| Cost Of Goods Sold | 1229629 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2530587 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2530587 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Total Revenue Column | 161957 | TotalRevenueColumn |
| Related Or Exempt Function Income | 161957 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 161957 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11398069 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7183800 | RelatedOrExemptFunctionIncome |
| Exclusion | $4,381 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82500 | Total |
| Program Services | 82500 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 519452 | Total |
| Program Services | 44887 | ProgramServices |
| Management And General | 474565 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4227786 | Total |
| Program Services | 3270551 | ProgramServices |
| Management And General | 957235 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132538 | Total |
| Program Services | 72896 | ProgramServices |
| Management And General | 59642 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 708109 | Total |
| Program Services | 394156 | ProgramServices |
| Management And General | 313953 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 397720 | Total |
| Program Services | 275728 | ProgramServices |
| Management And General | 121992 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1175 | Total |
| Management And General | 1175 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27000 | Total |
| Management And General | 27000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 662648 | Total |
| Program Services | 392905 | ProgramServices |
| Management And General | 269743 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66571 | Total |
| Program Services | 47264 | ProgramServices |
| Management And General | 19307 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150060 | Total |
| Program Services | 95026 | ProgramServices |
| Management And General | 55034 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269872 | Total |
| Program Services | 158258 | ProgramServices |
| Management And General | 111614 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 128957 | Total |
| Program Services | 63783 | ProgramServices |
| Management And General | 65174 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129165 | Total |
| Management And General | 129165 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 323315 | Total |
| Program Services | 62258 | ProgramServices |
| Management And General | 261057 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33260 | Total |
| Program Services | 6379 | ProgramServices |
| Management And General | 26881 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 2581472 | 2581472 | |
| REPAIR AND MAINTENANCE | 147125 | 93227 | 53898 |
| DUES AND SUBSCRIPTIONS | 57451 | 17521 | 39930 |
| EQUIPMENT RENTAL | 51294 | 3446 | 47848 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34118 | Total |
| Program Services | 8475 | ProgramServices |
| Management And General | 25643 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10731588 | Total |
| Program Services | 7670732 | ProgramServices |
| Management And General | 3060856 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124809 | BOY |
| EOY | 685328 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 831643 | BOY |
| EOY | 1204045 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 821311 | BOY |
| EOY | 646794 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109124 | BOY |
| EOY | 109195 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108018 | BOY |
| EOY | 83471 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7530659 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2099858 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5620125 | BOY |
| EOY | 5430801 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7615030 | BOY |
| EOY | 8159634 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 510615 | BOY |
| EOY | 715295 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2916811 | BOY |
| EOY | 2562254 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3427426 | BOY |
| EOY | 3277549 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4187071 | BOY |
| EOY | 4881552 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 533 | BOY |
| EOY | 533 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4187604 | BOY |
| EOY | 4882085 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7615030 | BOY |
| EOY | 8159634 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 666481 | ReconcilationRevenueExpenses |
| Reconcilation Donated Services | 28000 | ReconcilationDonatedServices |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 363841 | OtherCostOrOtherBasis |
| Book Value | 363841 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5763385 | OtherCostOrOtherBasis |
| Depreciation | 1342669 | Depreciation |
| Book Value | 4420716 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31921 | OtherCostOrOtherBasis |
| Depreciation | 14717 | Depreciation |
| Book Value | 17204 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1371512 | OtherCostOrOtherBasis |
| Depreciation | 742472 | Depreciation |
| Book Value | 629040 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5430801 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 12679593 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 28000 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 1253524 | OtherRevenues |
| Revenue Not Rptd F990 | 1281524 | RevenueNotRptdF990 |
| Revenue Subtotal | 11398069 | RevenueSubtotal |
| Total Revenue Per Form990 | 11398069 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11985112 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 1253524 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1253524 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10731588 | ExpensesSubtotal |
| Total Expenses Per Form990 | 10731588 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 2D | COST OF GOODS SOLD 1,229,629 RENTAL EXPENSES 23,895 |
| EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 2D | COST OF GOODS SOLD 1,229,629 RENTAL EXPENSES 23,895 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | false | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALCONA HEALTH CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 177 NORTH BARLOW RD | AddressLine1 |
| City | LINCOLN | City |
| State | MI | State |
| ZIP Code | 48742 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 382170985 | EINOfRecipient |
| Amount Of Cash Grant | 82500 | AmountOfCashGrant |
| Purpose Of Grant | BEHAVIORAL HEALTH | PurposeOfGrant |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|
| MARION HAUTEA | ||||
| CMO | 224435 | 18791 | 243226 | 220000 |
| MICHELLE STYMA | ||||
| CEO | 159054 | 16802 | 175856 | 158047 |
| JEMELLEE JACALA-TADIAN | ||||
| PHYSICIAN | 180500 | 17592 | 198092 | 180249 |
| TIMOTHY HAYES | ||||
| PHYSICIAN | 160500 | 10513 | 171013 | 168103 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1833627 | NoncashContribsRptdF990 |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | DEBT FORGIVENES | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 213703 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FINANCE COMMITTEE REVIEWS THE FORM 990 BEFORE IT IS FILED AND PRESENTS IT TO THE BOARD. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | EMPLOYEES AND BOARD MEMBERS MUST SUBMIT IN WRITING IF THEY HAVE A CONFLICT OF INTEREST FOR EXECUTIVE TEAM REVIEW. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | FOR THE CEO,THE HUMAN RESOURCES DEPARTMENT RESEARCHES PREVAILING WAGE RATES FROM FOUR SOURCES AND REPORTS THEM TO THE GOVERNING BOARD EXECUTIVE TEAM. THE GOVERNING BOARD EXECUTIVE TEAM REPORTS TO THE FINANCE COMMITTEE AND DETERMINES A WAGE TO BE PRESENTED AND APPROVED BY THE BOARD. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION OF OFFICERS AND KEY EMPLOYEES IS BASED OFF THE BOARD APPROVED WAGE SCALE. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| RECONCILIATION OF CHANGES - OTHER | FORM 990, PART XI, LINE 9 | COST OF GOODS SOLD 1,229,629 RENTAL EXPENSES 23,895 COST OF GOODS SOLD -1,229,629 RENTAL EXPENSES -23,895 |