2013-05-10T07:14:33-05:00 2012-06-30 381357951 PLANTE & MORAN PLLC 600 E FRONT ST SUITE 300 TRAVERSE CITY MI 49686 990 2011-07-01 383022945 PORTAGE HEALTH FOUNDATION PORT 9064878000 500 CAMPUS DRIVE HANCOCK MI 49930 BRIAN DONAHUE 9064878000 2013-05-06 1 P00053797 2319477800 2011 2016-02-24 21:20:13Z JAMES BOGAN 500 CAMPUS DRIVE HANCOCK MI 49930 1343700 0 X WWW.PORTAGEHEALTH.ORG X 1990 MI TO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX-EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE. 14 12 0 12 0 0 59843 57648 0 0 114366 74718 1283 -2062 175492 130304 80890 31690 0 0 0 0 0 0 0 12764 10326 93654 42016 81838 88288 1829426 1891937 0 0 1829426 1891937 TO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE. 0 0 30440 30440 0 PROMOTION OF CHARITABLE MISSION OF RELATED TAX-EXEMPT HEALTHCARE ENTITY 1000 1000 0 GAS CARDS FOR TRAVELING RADIATION PATIENTS 250 250 0 OUTSTANDING NURSING AWARD 31690 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 14 12 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 0 0 1 0 0 MI X BRIAN DONAHUE CFO 9064831503 500 CAMPUS DRIVE HANCOCK MI 49930 X PAUL OLLILA 1.00 X 0 0 0 NANCY FENTON 1.00 X 0 0 0 TERRY KINZEL MD 1.00 X 0 191464 13840 JEANNE KURTZ 1.00 X 0 0 0 LENNON MATTILA HUGHES 1.00 X X 0 0 0 WILLIAM POLKINGHORNE 1.00 X 0 0 0 GERARD QUELLO 1.00 X X 0 0 0 ROGER HELMAN JD CFP 1.00 X X 0 0 0 DANA JOHNSON PHD 1.00 X 0 0 0 MICHELE BLAU 1.00 X 0 0 0 ROBERT MIKESCH 1.00 X 0 0 0 BRENT PETERSON 1.00 X 0 0 0 BERNADETTE YEOLMAN-QUELLETTE 1.00 X 0 0 0 KEVIN STORE 1.00 X X 0 134774 23358 JAMES BOGAN 1.00 X 0 333802 33293 BRIAN DONAHUE 1.00 X 0 185585 17674 0 845625 88165 0 0 1 0 0 39065 18583 57648 51744 51744 1227263 1204289 22974 22974 22974 7045 39065 9107 -2062 -2062 130304 0 0 72656 30440 30440 1250 1250 10315 10315 ACCOUNTING CORRECTION 11 11 42016 31690 10326 0 56077 49728 444887 549306 18615 18615 0 0 1312407 1276884 16055 16019 1829426 1891937 0 0 X 1829426 1891937 1829426 1891937 1829426 1891937 X 88288 -25777 X X 0 1 1 X 0 X X X 0 0 0 PORTAGE HEALTH INC 381381288 3 0 0 1 30440 1 30440 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1773348 31535 47838 10513 1842208 1557595 20390 205536 10173 1773348 1501685 27263 38238 9591 1557595 1672098 21989 -183299 9103 1501685 0.99100 0.00900 0.00000 1 0 18615 18615 0 0 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. SPRING BALL 25870 20350 5520 5520 AUCTION 18715 18715 2037 1 1525 0 1525 900 430 220 46110 39065 7045 900 2037 5520 430 220 9107 -2062 1 PORTAGE HEALTH INC 500 CAMPUS DRIVE HANCOCK MI 49930 381381288 501(C)3 30000 0 N/A N/A EMERGENCY SERVICES PORTAGE HEALTH INC 500 CAMPUS DRIVE HANCOCK MI 49930 381381288 501(C)3 440 0 N/A N/A AUDIOLOGY SERVICES 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE 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. 0 0 0 0 0 0 0 0 0 TERRY KINZEL MD 0 166864 0 24600 0 0 0 12693 0 1147 0 205304 0 0 KEVIN STORE 0 51774 0 83000 0 0 0 11120 0 12238 0 158132 0 0 JAMES BOGAN 0 259582 0 68515 0 5705 0 17850 0 15443 0 367095 0 0 BRIAN DONAHUE 0 158635 0 26492 0 458 0 13132 0 4542 0 203259 0 0 SUPPLEMENTAL INFORMATION PART III SCHEDULE 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. FORM 990, PART VI, SECTION A, LINE 7A ELECTION AND RE-ELECTION OF ALL MEMBERS OF THE FOUNDATION BOARD OF DIRECTORS SHALL BE, INDIVIDUALLY OR COLLECTIVELY, BY AFFIRMATIVE ACTION OF THE BOARD OF DIRECTORS OF PORTAGE HEALTH. THE FOUNDATION BOARD SHALL NOMINATE CANDIDATES FOR ELECTION OR RE-ELECTION AS DIRECTORS BY RESOLUTION AND SUBMIT SUCH NOMINATIONS TO THE PORTAGE HEALTH BOARD OF DIRECTORS FOR RATIFICATION. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS OF THE FOUNDATION MAY PROPOSE AMENDMENTS TO THE BOARD BYLAWS, WHICH MUST BE THEN SUBMITTED FOR APPROVAL BY THE BOARD OF DIRECTORS OF PORTAGE HEALTH. FORM 990, PART VI, SECTION B, LINE 11 THE 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 12C AN ANNUAL CONFLICT OF INTEREST STATEMENT IS COMPLETED AND SIGNED BY EACH BOARD MEMBER. THE PRESIDENT AND CEO REVIEWS THE COMPLETED CONFLICT OF INTEREST FORMS. IF A CONFLICT IS IDENTIFIED, THAT BOARD MEMBER IS EXCUSED FROM ANY DICUSSION OR VOTE RELATING TO THE IDENTIFIED CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A OCCASIONALLY, 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 19 THE 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 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -25,777. 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. PORTAGE HEALTH INC 500 CAMPUS DRIVE HANCOCK MI 49930 381381288 IMPROVING HEALTH OF COMMUNITY BY PROVIDING HIGH QUALITY HEALTHCARE SERVICES MI 501(C)3 LINE 3 N/A 0 PORTAGE HEALTH RESOURCES INC 500 CAMPUS DRIVE HANCOCK MI 49930 383041729 SENIOR MEALS MI 501(C)3 LINE 11A, I PORTAGE HEALTH INC 1 PORTAGE HEALTH HOME SERVICES INC 500 CAMPUS DRIVE HANCOCK MI 49930 383565553 PRIVATE DUTY CARE MI 501(C)3 LINE 9 PORTAGE HEALTH INC 1 COPPER COUNTRY APOTHECARIES INC 500 CAMPUS DRIVE HANCOCK MI 49930 302083778 RETAIL PHARMACY MI N/A C 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0