COPPER SHORES COMMUNITY HEALTH FOUNDATION: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COPPER SHORES COMMUNITY HEALTH FOUNDATION (EIN 38-3022945)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-06-13
- IRS object ID
- 201111649349300131
- Schema version
- 2009v1.7
- 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 | 2011-06-13T15:36:24-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 E Front St Suite 300 | AddressLine1 |
| City | Traverse City | City |
| State | MI | State |
| ZIP Code | 49686 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383022945 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTAGE HEALTH FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PORT | NameControl |
| Phone | 9064878000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 CAMPUS DRIVE | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN DONAHUE | Name |
| Title | CFO | Title |
| Phone | 9064878000 | Phone |
| Date Signed | 2011-06-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2319477800 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES BOGAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 CAMPUS DRIVE | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 934501 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.PORTAGEHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX-EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 63948 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 55225 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -45531 | InvestmentIncomePriorYear |
| Investment Income Current Year | 45731 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3282 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11269 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 21699 | TotalRevenuePriorYear |
| Total Revenue Current Year | 112225 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 68900 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 106289 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 17767 | OtherExpensePriorYear |
| Other Expenses Current Year | 23909 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 86667 | TotalExpensesPriorYear |
| Total Expenses Current Year | 130198 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -64968 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -17973 | RevenuesLessExpensesCY |
| Total Assets BOY | 1545801 | TotalAssetsBOY |
| Total Assets EOY | 1603405 | TotalAssetsEOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1545801 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1603405 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO SUPPORT AND ASSIST THE MISSION OF PORTAGE HEALTH, A TAX EXEMPT HEALTHCARE ORGANIZATION, THROUGH FINANCIAL ASSISTANCE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 103495 | Expense |
| Grants | 101339 | Grants |
| Description | PROMOTION OF CHARITABLE MISSION OF RELATED TAX-EXEMPT HEALTHCARE ENTITY | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4700 | Expense |
| Grants | 4700 | Grants |
| Description | GRANT TO AGES PROGRAM | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 12581 | Expense |
| Grants | 250 | Grants |
| Description | ALL OTHER PROGRAM SERVICES | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 12581 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 250 | TotalOfOtherProgramServiceGrnt |
| Total Program Service Expense | 120776 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN DONAHUE CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9064831503 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 CAMPUS DRIVE | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| PAUL OLLILA | ||||||
| direCTOR | 1.00 | X | 0 | 0 | 0 | |
| NANCY FENTON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| TERRY KINZEL MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 38581 | 238 | |
| JEANNE KURTZ | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LENNON MATTILA HUGHES | ||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X |
| PETER WICKLEY | ||||||
| DireCTOR | 1.00 | X | 0 | 0 | 0 | |
| WILLIAM POLKINGHORNE | ||||||
| DireCTOR | 1.00 | X | 0 | 0 | 0 | |
| GERARD QUELLO | ||||||
| SECRETARY/TREASURER | 1.00 | X | 0 | 0 | 0 | X |
| ROGER HELMAN JD CFP | ||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | X |
| DANA JOHNSON PHD | ||||||
| DIreCTOR | 1.00 | X | 0 | 0 | 0 | |
| MICHELE BLAU | ||||||
| DireCTOR | 1.00 | X | 0 | 0 | 0 | |
| BOB MIKESCH | ||||||
| DireCTOR | 1.00 | X | 0 | 0 | 0 | |
| BRENT PETERSON | ||||||
| DireCTOR | 1.00 | X | 0 | 0 | 0 | |
| PICHAI SRIPAIPAN | ||||||
| DIreCTOR | 1.00 | X | 0 | 243543 | 23339 | |
| BERNADETTE YEOMAN-QUELLETTE | ||||||
| DireCTOR | 1.00 | X | 0 | 0 | 0 | |
| JAMES BOGAN | ||||||
| PRESIDENT AND CEO | 1.00 | 0 | 282884 | 35420 | X | |
| BRIAN DONAHUE | ||||||
| VP FINANCE AND CFO | 1.00 | 0 | 168980 | 23862 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 733988 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 82859 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 27683 | FundraisingEvents |
| All Other Contributions | 27542 | AllOtherContributions |
| Total Contributions | 55225 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59161 | TotalRevenueColumn |
| Exclusion | $59,161 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 808196 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 821626 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -13430 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -13430 | TotalRevenueColumn |
| Exclusion | -$13,430 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 11919 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 27683 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 650 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11269 | TotalRevenueColumn |
| Exclusion | $11,269 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 112225 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $57,000 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106039 | Total |
| Program Services | 106039 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250 | Total |
| Program Services | 250 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9422 | Total |
| Management And General | 9422 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2232 | Total |
| Program Services | 2232 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| ENDOWMENT FUND - OTHER | 11000 | 11000 |
| ENDOWMENT FUND - AUDIOL | 600 | 600 |
| OTHER EXPENSE | 500 | 500 |
| AWARD ENGRAVING | 155 | 155 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130198 | Total |
| Program Services | 120776 | ProgramServices |
| Management And General | 9422 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41125 | BOY |
| EOY | 42819 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 614000 | BOY |
| EOY | 501235 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18615 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18615 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2991 | BOY |
| EOY | 0 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 876616 | BOY |
| EOY | 1047266 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11069 | BOY |
| EOY | 12085 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1545801 | BOY |
| EOY | 1603405 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1545801 | BOY |
| EOY | 1603405 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1545801 | BOY |
| EOY | 1603405 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1545801 | BOY |
| EOY | 1603405 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTAGE HEALTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381381288 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 0 | ListedInGoverningDoc |
| Supported Organization Notified | 0 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $101,339 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 101339 | SumOfAmounts |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1501685 | BeginningOfYearBalance |
| Contributions | 27263 | Contributions |
| Investment Earnings Or Losses | 38238 | InvestmentEarningsOrLosses |
| Administrative Expenses | 9591 | AdministrativeExpenses |
| End Of Year Balance | 1557595 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1672098 | BeginningOfYearBalance |
| Contributions | 21989 | Contributions |
| Investment Earnings Or Losses | -183299 | InvestmentEarningsOrLosses |
| Administrative Expenses | 9103 | AdministrativeExpenses |
| End Of Year Balance | 1501685 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.99600 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00400 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18615 | OtherCostOrOtherBasis |
| Depreciation | 18615 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
| Total Revenue | 112225 | TotalRevenue |
| Total Expenses | 130198 | TotalExpenses |
| Excess Or Deficit For Year | -17973 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 75577 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 75577 | TotalAdjustments |
| Excess Or Deficit Per FS | 57604 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part V, Line 4: | Identifier |
| Return Reference | Description of Intended Use of Endowment Funds: | ReturnReference |
| Explanation | THE ENDOWMENT FUNDS ARE TO BE USED FOR GRANTING WITHIN PORTAGE HEALTH, INC. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SPRING BALL | NameOfEvent1 |
| Gross Receipts Event1 | 21505 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 16480 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 5025 | GrossRevenueEvent1 |
| Name Of Event2 | AUCTION | NameOfEvent2 |
| Gross Receipts Event2 | 18097 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 11203 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 6894 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 650 | NonCashPrizesEvent2 |
| Gross Receipts Total | 39602 | GrossReceiptsTotal |
| Charitable Contributions Total | 27683 | CharitableContributionsTotal |
| Gross Revenue Total Events | 11919 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 650 | NonCashPrizesTotalEvents |
| Direct Expense Summary Events | 650 | DirectExpenseSummaryEvents |
| Net Income Summary | 11269 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| PORTAGE HEALTH INC | |||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 5181 | WIRELESS INTERNET ACCESS SERVICE ENHANCEMENT |
| PORTAGE HEALTH INC | |||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 11176 | SPINNING INDOOR CYCLING CLASS |
| PORTAGE HEALTH INC | |||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 58650 | GENEXPERT IV MACHINE |
| PORTAGE HEALTH INC | |||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 1332 | BABYSENSE FEATURE FOR HUGS SYSTEM |
| PORTAGE HEALTH INC | |||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 381381288 | 501(C)3 | 25000 | PHYSICIAN RECRUITMENT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PICHAI SRIPAIPAN | |||||||||||||
| 0 | 133076 | 0 | 110367 | 0 | 100 | 0 | 16832 | 0 | 6507 | 0 | 266882 | 0 | 0 |
| JAMES BOGAN | |||||||||||||
| 0 | 251534 | 0 | 18000 | 0 | 13350 | 0 | 18450 | 0 | 16970 | 0 | 318304 | 0 | 0 |
| BRIAN DONAHUE | |||||||||||||
| 0 | 158464 | 0 | 10316 | 0 | 200 | 0 | 12535 | 0 | 11327 | 0 | 192842 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | SCHEDULE J, PART I, LINE 3: THE FOLLOWING INDIVIDUALS ARE COMPENSATED BY RELATED ORGANIZATION PORTAGE HEALTH, INC.: JAMES BOGAN, PRESIDENT AND CEO BRIAN DONAHUE, VICE PRESIDENT AND CFO PICHAI SRIPAIPAN, DIRECTOR THEY UTILIZE A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANTS, WRITTEN EMPLOYEMENT CONTRACTS, COMPENSATION SURVEY OR STUDIES, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THEIR COMPENSATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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 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 OCTOBER 2010. |
| 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. FOR WHICH COMPENSATION IS REPORTED IN COLUMNS E & F: JAMES BOGAN 40 HOURS BRIAN DONAHUE 40 HOURS PICHAI SRIPAIPAN 40 HOURS TERRY KINZEL, MD 24 HOURS |
| FORM 990, PART XI, LINE 2B: | THE FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTANT ON A CONSOLIDATED BASIS. |
| FORM 990, PART XI, 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/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |
| PORTAGE HEALTH RESOURCES INC | ||||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 383041729 | SENIOR MEALS | MI | 501(C)3 | Line 11a, I | PORTAGE HEALTH INC | |
| PORTAGE HEALTH HOME SERVICES INC | ||||||||||
| 500 CAMPUS DRIVE | HANCOCK | MI | 49930 | 383565553 | PRIVATE DUTY CARE | MI | 501(C)3 | Line 9 | PORTAGE HEALTH INC | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COPPER COUNTRY APOTHECARIES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 CAMPUS DRIVE | AddressLine1 |
| City | HANCOCK | City |
| State | MI | State |
| ZIP Code | 49930 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 302083778 | EIN |
| Primary Activity | RETAIL PHARMACY | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTAGE HEALTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionType |
| Amount Involved | 101339 | AmountInvolved |