2012-08-13T12:36:02-05:00 2011-12-31 381337372 BEENE GARTER LLP 56 GRANDVILLE AVE SW SUITE 100 GRAND RAPIDS MI 495034036 990 2011-01-01 200602574 HOLLAND COMMUNITY HEALTH CENTER HOLL 6163943788 336 S RIVER AVE HOLLAND MI 494233326 BRIAN VAN HALL 6163943788 2012-07-26 1 MARGARET W BISHOP CPA P00295096 6162355200 2011 2016-02-24 21:20:13Z BRIAN VAN HALL 336 S RIVER AVE HOLLAND MI 494233326 1486267 0 X N/A X 2004 MI TO PROVIDE ACCESS TO QUALITY PRIMARY HEALTH CARE FOR ALL MEMBERS OF THE COMMUNITY WITH BOTH RESPECT AND COMPASSION. 5 5 0 110 0 0 824289 684013 748676 802254 0 0 6535 0 1579500 1486267 3874 0 0 0 0 0 0 0 0 1577626 1486267 1581500 1486267 -2000 0 126897 188395 126897 188395 0 0 TO IMPROVE THE HEALTH OF THE PATIENTS IN THE HOLLAND COMMUNITY BY PROVIDING QUALITY HEALTH CARE REGARDLESS OF LANGUAGE, FINANCIAL OR CULTURAL BARRIERS; THEREBY ASSURING THAT PRIMARY HEALTH CARE IS ACCESSIBLE TO ALL RESIDENTS OF THE AREA. 0 0 1393266 802254 PROVIDED APPROXIMATELY 11,900 PATIENT HEALTH CARE VISITS. 1393266 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 MI X JIM JUNEWICK 6164642845 4100 LAKE DRIVE SE STE 300 GRAND RAPIDS MI 49546 X DALE SOWDERS 1.00 X X 0 0 0 BRIAN VAN HALL 1.00 X X 0 0 0 SAMIR RAJANI MD 1.00 X 0 0 0 NANCY MACDONALD MD 1.00 X 0 0 0 JEAN MARTIN 1.00 X 0 0 0 CHERYL PIERRE 1.00 X 0 0 0 BRANDON YODER 1.00 X 0 0 0 0 0 0 0 0 0 0 SPECTRUM HEALTH MEDICAL GROUP 4100 LAKE DR SE STE 300 GRAND RAPIDS MI 49546 SEE SCHEDULE O 1155597 1 684013 684013 PATIENT FEES 621400 751832 751832 PHYSICIAN INCENTIVES 621400 50422 50422 802254 1486267 802254 0 0 75000 75000 18001 18001 1080597 1080597 127761 127761 66655 66655 1782 1782 9982 9982 16268 16268 BAD DEBT EXPENSE 74010 74010 BANK SERVICE CHARGE 5745 5745 MISCELLANEOUS 4056 4056 ON- CALL NURSE 3894 3894 2516 2516 1486267 1393266 93001 0 43631 156788 83266 31607 126897 188395 126897 188395 126897 188395 X 0 0 126897 188395 0 0 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1486267 1486267 0 1705879 219612 219612 1486267 0 1486267 1705879 219612 219612 1486267 0 1486267 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE INTERNAL REVENUE SERVICE HAS DETERMINED THE CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER PROVISIONS OF CODE SECTION 501(C)(3) WHEREBY ONLY UNRELATED BUSINESS INCOME, AS DEFINED BY SECTION 509(A)(1) OF THE CODE, IS SUBJECT TO FEDERAL INCOME TAX. THE CENTER CURRENTLY HAS NO UNRELATED BUSINESS ACTIVITY. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. IN ADDITION, THE CENTER QUILIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). TAX POSITIONS TAKEN ARE ASSESSED FOR UNCERTAINTY AND A PROVISION MAY BE RECORDED IF A TAX POSITION IS NOT LIKELY TO BE SUSTAINED UPON EXAMINATION. WITH LIMITED EXCEPTIONS, THE CENTER IS NO LONGER SUBJECT TO TAX AUDITS BY FEDERAL AUTHORITIES FOR YEARS PRIOR TO 2008. BVAN HALL DR RAJANI DR MACDONA EMPLOYEES OF SHMG AND BOARD MEMBERS/OFFICERS OF HCHC 1422407 SHMG IS REIMBURSED FOR EXPENSES THEY PAY ON BEHALF OF HCHC. 0 DALE SOWDERS EMPLOYEE OF HOLLAND HOSPITAL AND BOARD MEMBER/OFFICER OF HCHC 63860 HH LEASES FACILITY TO HCHC 0 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITHIN THE GOVERNING BODY FORM 990, PART VI, SECTION B, LINE 11 BRIAN VAN HALL (BOARD MEMBER) REVIEWS THE FORM PRIOR TO FILING. THE COMPLETED AND FILED FORM 990 IS PRESENTED TO THE BOARD, HOWEVER, THERE IS NO REVIEW PROCESS BY THE ENTIRE BOARD OF DIRECTORS OF THE FORM 990 PRIOR TO IT'S FILING. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990 PART XI, LINE 2C THERE IS NO FORMAL COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, HOWEVER, THE BOARD OF DIRECTORS SERVES THIS FUNCTION. THERE HAS BEEN NO CHANGE OF THIS PROCESS FROM THE PRIOR YEARS. FORM 990, PART VII, SECTION A, LINE 1 BRIAN VAN HALL IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. CHERYL PIERRE WAS COMPENSATED FOR HER WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT WAS NOT COMPENSATED FOR HER TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. DALE SOWDERS RECEIVES COMPENSATION FOR HIS WORK AT HOLLAND HOSPITAL, WHICH IS A FOUNDING MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. NANCY MACDONALD, M.D. RECEIVES COMPENSATION FOR HER WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HER TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. BRANDON YODER IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. SAMIR RAJANI, M.D. IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP, WHICH IS A MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HIS TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 13-14 HCHC DOES NOT HAVE A FORMAL WRITTEN WHISTLEBLOWER POLICY OR WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. THEY ADHERE TO THE POLICIES THAT HAVE BEEN SET FORTH BY SPECTRUM HEALTH MEDICAL GROUP. FORM 990, PART VII, SECTION B, LINE 1(B) SPECTRUM HEALTH MEDICAL GROUP PAYS ALL OPERATING EXPENSES OF HCHC AND IS REIMBURSED BY HCHC. HOLLAND COMMUNITY HOSPITALS 602 MICHIGAN AVENUE HOLLAND MI 49423 382800065 HEALTH CARE NEEDS OF THE HOLLAND COMMUNITY MI 501(C)(3) 3 N/A 0 SPECTRUM HEALTH PRIMARY CARE PARTNERS DBA SPECTRUM HEALTH MEDICAL GROUP 4100 LAKE DR SE STE 300 GRAND RAPIDS MI 49546 381358164 PHYSICIAN OWNED MULTI-SPECIALITY GROUP DEDICTATED TO TOTAL HEALTH CARE NEEDS MI C 0 0 1 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 SPECTRUM HEALTH MEDICAL GROUP L 1155597 COSTS PAID SPECTRUM HEALTH MEDICAL GROUP O 266810 COSTS PAID HOLLAND COMMUNITY HOSPITAL C 684013 PAYMENTS RECEIVED AND DUE HOLLAND COMMUNITY HOSPITAL J 63860 RENT PAID