FURP.ORG / PUBLIC DATA EXPLORER

COPPER SHORES COMMUNITY HEALTH FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COPPER SHORES COMMUNITY HEALTH FOUNDATION (EIN 38-3022945)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-10
IRS object ID
201341309349300409
Schema version
2011v1.5
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)
Timestamp2013-05-10T07:14:33-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

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 Line1600 E FRONT ST SUITE 300AddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49686ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN383022945EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PORTAGE HEALTH FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPORTNameControl
Phone9064878000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 CAMPUS DRIVEAddressLine1
CityHANCOCKCity
StateMIState
ZIP Code49930ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRIAN DONAHUEName
TitleCFOTitle
Phone9064878000Phone
Date Signed2013-05-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
PTINP00053797PTIN
Phone2319477800Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES BOGANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1500 CAMPUS DRIVEAddressLine1
CityHANCOCKCity
StateMIState
ZIP Code49930ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1343700GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PORTAGEHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1990YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX-EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year59843ContributionsGrantsPriorYear
Contributions Grants Current Year57648ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year114366InvestmentIncomePriorYear
Investment Income Current Year74718InvestmentIncomeCurrentYear
Other Revenue Prior Year1283OtherRevenuePriorYear
Other Revenue Current Year-2062OtherRevenueCurrentYear
Total Revenue Prior Year175492TotalRevenuePriorYear
Total Revenue Current Year130304TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year80890GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY31690GrantsAndSimilarAmntsCY
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 Year12764OtherExpensePriorYear
Other Expenses Current Year10326OtherExpensesCurrentYear
Total Expenses Prior Year93654TotalExpensesPriorYear
Total Expenses Current Year42016TotalExpensesCurrentYear
Revenues Less Expenses Prior Year81838RevenuesLessExpensesPriorYear
Revenues Less Expenses CY88288RevenuesLessExpensesCY
Total Assets BOY1829426TotalAssetsBOY
Total Assets EOY1891937TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1829426NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1891937NetAssetsOrFundBalancesEOY
Mission DescriptionTO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense30440Expense
Grants30440Grants
Revenue0Revenue
DescriptionPROMOTION OF CHARITABLE MISSION OF RELATED TAX-EXEMPT HEALTHCARE ENTITYDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1000Expense
Grants1000Grants
Revenue0Revenue
DescriptionGAS CARDS FOR TRAVELING RADIATION PATIENTSDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense250Expense
Grants250Grants
Revenue0Revenue
DescriptionOUTSTANDING NURSING AWARDDescription
FieldValueIRS element (for citing)
Total Program Service Expense31690TotalProgramServiceExpense
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 Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Entity0TransactionRelatedEntity
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 Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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 Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
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 Line1BRIAN DONAHUE CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9064831503TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 CAMPUS DRIVEAddressLine1
CityHANCOCKCity
StateMIState
ZIP Code49930ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
PAUL OLLILA
DIRECTOR1.00X000
NANCY FENTON
DIRECTOR1.00X000
TERRY KINZEL MD
DIRECTOR1.00X019146413840
JEANNE KURTZ
DIRECTOR1.00X000
LENNON MATTILA HUGHES
CHAIR1.00X000X
WILLIAM POLKINGHORNE
DIRECTOR1.00X000
GERARD QUELLO
SECRETARY/TREASURER1.00X000X
ROGER HELMAN JD CFP
VICE CHAIR1.00X000X
DANA JOHNSON PHD
DIRECTOR1.00X000
MICHELE BLAU
DIRECTOR1.00X000
ROBERT MIKESCH
DIRECTOR1.00X000
BRENT PETERSON
DIRECTOR1.00X000
BERNADETTE YEOLMAN-QUELLETTE
DIRECTOR1.00X000
KEVIN STORE
EXECUTIVE DIRECTOR1.00X013477423358X
JAMES BOGAN
PRESIDENT AND CEO1.00033380233293X
BRIAN DONAHUE
VP FINANCE AND CFO1.00018558517674X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs845625TotalReportableCompFrmRltdOrgs
Total Other Compensation88165TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events39065FundraisingEvents
All Other Contributions18583AllOtherContributions
Total Contributions57648TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column51744TotalRevenueColumn
Exclusion$51,744ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1227263Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1204289Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities22974Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column22974TotalRevenueColumn
Exclusion$22,974ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events7045GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events39065CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses9107FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-2062TotalRevenueColumn
Exclusion-$2,062ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column130304TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$72,656ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total30440Total
Program Services30440ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1250Total
Program Services1250ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total10315Total
Management And General10315ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionACCOUNTING CORRECTIONDescription
Total11Total
Management And General11ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total42016Total
Program Services31690ProgramServices
Management And General10326ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY56077BOY
EOY49728EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY444887BOY
EOY549306EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18615LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec18615LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1312407BOY
EOY1276884EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY16055BOY
EOY16019EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1829426BOY
EOY1891937EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1829426BOY
EOY1891937EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1829426BOY
EOY1891937EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1829426BOY
EOY1891937EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses88288ReconcilationRevenueExpenses
Reconcilation Other Changes-25777ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1PORTAGE HEALTH INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN381381288EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc0ListedInGoverningDoc
Supported Organization Notified0SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$30,440Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts30440SumOfAmounts

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 Balance1773348BeginningOfYearBalance
Contributions31535Contributions
Investment Earnings Or Losses47838InvestmentEarningsOrLosses
Administrative Expenses10513AdministrativeExpenses
End Of Year Balance1842208EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1557595BeginningOfYearBalance
Contributions20390Contributions
Investment Earnings Or Losses205536InvestmentEarningsOrLosses
Administrative Expenses10173AdministrativeExpenses
End Of Year Balance1773348EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1501685BeginningOfYearBalance
Contributions27263Contributions
Investment Earnings Or Losses38238InvestmentEarningsOrLosses
Administrative Expenses9591AdministrativeExpenses
End Of Year Balance1557595EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1672098BeginningOfYearBalance
Contributions21989Contributions
Investment Earnings Or Losses-183299InvestmentEarningsOrLosses
Administrative Expenses9103AdministrativeExpenses
End Of Year Balance1501685EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.99100BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00900PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis18615OtherCostOrOtherBasis
Depreciation18615Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
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: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, 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.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SPRING BALLNameOfEvent1
Gross Receipts Event125870GrossReceiptsEvent1
Charitable Contributions Event120350CharitableContributionsEvent1
Gross Revenue Event15520GrossRevenueEvent1
Food And Beverage Event15520FoodAndBeverageEvent1
Name Of Event2AUCTIONNameOfEvent2
Gross Receipts Event218715GrossReceiptsEvent2
Charitable Contributions Event218715CharitableContributionsEvent2
Non Cash Prizes Event22037NonCashPrizesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events1525GrossReceiptsOtherEvents
Charitable Contrib Other Events0CharitableContribOtherEvents
Gross Revenue Other Events1525GrossRevenueOtherEvents
Cash Prizes Other Events900CashPrizesOtherEvents
Entertainment Other Events430EntertainmentOtherEvents
Other Direct Expenses Other Events220OtherDirectExpensesOtherEvents
Gross Receipts Total46110GrossReceiptsTotal
Charitable Contributions Total39065CharitableContributionsTotal
Gross Revenue Total Events7045GrossRevenueTotalEvents
Cash Prizes Total Events900CashPrizesTotalEvents
Non Cash Prizes Total Events2037NonCashPrizesTotalEvents
Food And Beverage Total Events5520FoodAndBeverageTotalEvents
Entertainment Total Events430EntertainmentTotalEvents
Other Direct Expenses Total Events220OtherDirectExpensesTotalEvents
Direct Expense Summary Events9107DirectExpenseSummaryEvents
Net Income Summary-2062NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
PORTAGE HEALTH INC
500 CAMPUS DRIVEHANCOCKMI49930381381288501(C)3300000N/AN/AEMERGENCY SERVICES
PORTAGE HEALTH INC
500 CAMPUS DRIVEHANCOCKMI49930381381288501(C)34400N/AN/AAUDIOLOGY SERVICES
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

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: A FINAL REPORT DETAILING THE NUMBER OF CLIENTS SERVED AND THE IMPACT OF GRANT FUNDS IS SUBMITTED TO PORTAGE HEALTH FOUNDATION AND RETAINED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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)

Base 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
TERRY KINZEL MD
01668640246000001269301147020530400
KEVIN STORE
05177408300000011120012238015813200
JAMES BOGAN
025958206851505705017850015443036709500
BRIAN DONAHUE
0158635026492045801313204542020325900

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationSCHEDULE J, PART I, LINE 3: THE CEO/EXECUTIVE DIRECTOR, JAMES BOGAN, IS COMPENSATED BY RELATED ORGANIZATION PORTAGE HEALTH, INC. 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 HIS COMPENSATION.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 7AELECTION 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 7BTHE 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 11THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER WITH BOARD MEMBERS AT A REGULARLY SCHEDULED BOARD MEETING. COPIES OF THE FORM 990 ARE PROVIDED TO EACH BOARD MEMBER FOR REVIEW AFTER THE RETURN HAS BEEN FILED.
FORM 990, PART VI, SECTION B, LINE 12CAN 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 15AOCCASIONALLY, AN INDEPENDENT CONSULTANT IS RETAINED TO RESEARCH THE MARKET DATA AND PERFORM COMPARISONS FOR THE CEO POSITION SHARED BY PORTAGE HEALTH FOUNDATION AND PORTAGE HEALTH, INC. THE RESULTS OF THE COMPARISON AND MARKET DATA ARE PRESENTED TO THE COMPENSATION COMMITTEE. IF NO OUTSIDE CONSULTANT IS RETAINED, MARKET SURVEYS ARE UTILIZED TO DETERMINE ADJUSTMENTS TO THE CEO'S COMPENSATION. IN EITHER CASE, THE COMPENSATION COMMITTEE RECOMMENDS ANY ADJUSTMENT TO PORTAGE HEALTH, INC.'S BOARD OF TRUSTEES. THE INDEPENDENT BOARD MEMBERS VOTE ON THE COMPENSATION AMOUNT AND IF APPROVED, IT IS FORMALLY PUT INTO A WRITTEN EMPLOYMENT CONTRACT AND DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE AND OF THE BOARD OF TRUSTEES. THIS PROCESS WAS LAST UNDERTAKEN IN 2011.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, SECTION A:THESE INDIVIDUALS DEVOTE THE FOLLOWING HOURS PER WEEK TO, RELATED ORGANIZATION, PORTAGE HEALTH, INC.: JAMES BOGAN 40 HOURS BRIAN DONAHUE 40 HOURS TERRY KINZEL, MD 41 HOURS KEVIN STORE 40 HOURS
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -25,777.CHANGES IN NET ASSETS OR FUND BALANCES:
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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
PORTAGE HEALTH INC
500 CAMPUS DRIVEHANCOCKMI49930381381288IMPROVING HEALTH OF COMMUNITY BY PROVIDING HIGH QUALITY HEALTHCARE SERVICESMI501(C)3LINE 3N/A0
PORTAGE HEALTH RESOURCES INC
500 CAMPUS DRIVEHANCOCKMI49930383041729SENIOR MEALSMI501(C)3LINE 11A, I1PORTAGE HEALTH INC
PORTAGE HEALTH HOME SERVICES INC
500 CAMPUS DRIVEHANCOCKMI49930383565553PRIVATE DUTY CAREMI501(C)3LINE 91PORTAGE HEALTH INC

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1COPPER COUNTRY APOTHECARIES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 CAMPUS DRIVEAddressLine1
CityHANCOCKCity
StateMIState
ZIP Code49930ZIPCode
FieldValueIRS element (for citing)
EIN302083778EIN
Primary ActivityRETAIL PHARMACYPrimaryActivity
Legal Domicile StateMILegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
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 Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg