FURP.ORG / PUBLIC DATA EXPLORER

HOLLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HOLLAND COMMUNITY HEALTH CENTER (EIN 20-0602574)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-08-05
IRS object ID
201112179349301211
Schema version
2010v3.2
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)
Timestamp2011-08-05T10:24:59-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BEENE GARTER LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line156 GRANDVILLE AVE SW SUITE 100AddressLine1
CityGRAND RAPIDSCity
StateMIState
ZIP Code495034036ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN200602574EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOLLAND COMMUNITY HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLLNameControl
Phone6163943788Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1336 S RIVER AVEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code494233326ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHERYL PIERREName
TitleBOARD MEMBERTitle
Phone6163943788Phone
Date Signed2011-07-26DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARGARET W BISHOP CPAName
Phone6162355200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHERYL PIERRENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1336 S RIVER AVEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code494233326ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1579500GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE ACCESS TO QUALITY PRIMARY HEALTH CARE FOR ALL MEMBERS OF THE COMMUNITY WITH BOTH RESPECT AND COMPASSION.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers120TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year849151ContributionsGrantsPriorYear
Contributions Grants Current Year824289ContributionsGrantsCurrentYear
Program Service Revenue Prior Year514177ProgramServiceRevenuePriorYear
Program Service Revenue CY748676ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year6535OtherRevenueCurrentYear
Total Revenue Prior Year1363328TotalRevenuePriorYear
Total Revenue Current Year1579500TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY3874GrantsAndSimilarAmntsCY
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 Year1361328OtherExpensePriorYear
Other Expenses Current Year1577626OtherExpensesCurrentYear
Total Expenses Prior Year1361328TotalExpensesPriorYear
Total Expenses Current Year1581500TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2000RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2000RevenuesLessExpensesCY
Total Assets BOY215312TotalAssetsBOY
Total Assets EOY126897TotalAssetsEOY
Total Liabilities BOY213312TotalLiabilitiesBOY
Total Liabilities EOY126897TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2000NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionTO 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1489090Expense
Revenue755211Revenue
DescriptionPROVIDED APPROXIMATELY 12,300 PATIENT HEALTH CARE VISITS.Description
Total Program Service Expense1489090TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
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 Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
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 Line1CECELIA PERKINSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6164642845TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14100 LAKE DRIVE SE STE 300AddressLine1
CityGRAND RAPIDSCity
StateMIState
ZIP Code49546ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
DALE SOWDERS
CHAIR1.00XX000
CHERYL PIERRE
DIRECTOR1.00XX000
SAMIR RAJANI MD
DIRECTOR1.00X000
NANCY MACDONALD MD
DIRECTOR1.00X000
JEAN MARTIN
DIRECTOR1.00X000
JAN PLASMAN
FORMER DIRECTOR1.00X000
CALVIN SIEGERS MD
FORMER DIRECTOR1.00X000
CECELIA PERKINS
OFFICER1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHIGAN MEDICAL PATIENT CAREBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14100 LAKE DR SE STE 300AddressLine1
CityGRAND RAPIDSCity
StateMIState
ZIP Code49546ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesSEE SCHEDULE ODescriptionOfServices
Compensation1152882Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations820789RelatedOrganizations
All Other Contributions3500AllOtherContributions
Total Contributions824289TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT FEESDescription
Business Code621400BusinessCode
Total Revenue Column748676TotalRevenueColumn
Related Or Exempt Function Income748676RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue748676TotalProgramServiceRevenue

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUSDescription
Business Code900099BusinessCode
Total Revenue Column6535TotalRevenueColumn
Related Or Exempt Function Income6535RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue6535TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1579500TotalRevenueColumn
Related Or Exempt Function Income755211RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total3874Total
Program Services3874ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total75000Total
Management And General75000ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total17410Total
Management And General17410ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1077882Total
Program Services1077882ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total176487Total
Program Services176487ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total64619Total
Program Services64619ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12215Total
Program Services12215ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total17147Total
Program Services17147ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT EXPENSE126852126852
ON- CALL NURSE51715171
MISCELLANEOUS32173217
REACH OUT AND READ16261626

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1581500Total
Program Services1489090ProgramServices
Management And General92410ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY159299BOY
EOY43631EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY56013BOY
EOY83266EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY215312BOY
EOY126897EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY213312BOY
EOY126897EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY213312BOY
EOY126897EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2000BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2000BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY215312BOY
EOY126897EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-2000ReconcilationRevenueExpenses
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue1579500TotalRevenue
Total Expenses1581500TotalExpenses
Excess Or Deficit For Year-2000ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-2000ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1760335TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities180835DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990180835RevenueNotRptdF990
Revenue Subtotal1579500RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901579500TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1762335TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities180835DonatedServicesUseOfFacilities
Expenses Not Rptd F990180835ExpensesNotRptdF990
Expenses Subtotal1581500ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901581500TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE 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 DEDUCTIONI 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 2007, AND STATE AUTHORITIES FOR YEARS PRIOR TO 2006.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
C PIERRE DR RAJANI DR MACDONAL
EMPLOYEES OF SHMG/MMPC AND BOARD MEMBERS/OFFICERS OF HCHC1513007MMPC IS REIMBURSED FOR EXPENSES THEY PAY ON BEHALF OF HCHC.0
DALE SOWDERS
EMPLOYEE OF HOLLAND HOSPITAL AND BOARD MEMBER/OFFICER OF HCHC64619HH LEASES FACILITY TO HCHC0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 4THE BYLAWS AND ARTICLES OF INCORPORATION WERE AMENDED TO CHANGE THE DEFINITION OF THE CLASSES OF MEMBERS. THE CLASS H MEMBER REMAINS HOLLAND COMMUNITY HOSPITAL AND THE CLASS P MEMBER WAS AMENDED TO BE LIMITED TO (A) MICHIGAN NONPROFIT CORPORATIONS ORGANIZED AND OPERATED FOR THE EMPLOYMENT OF PHYSICIANS, (B) PHYSICIAN-OWNED PROFESSIONAL CORPORATIONS OR LIMITED LIABILITY COMPANIES OR (C) OTHER PHYSICIAN GROUPS PRACTICING IN THE HOLLAND, MICHIGAN AREA. THIS AMENDMENT WAS IMPLEMENTED FOR THE CHANGE OF THE CLASS P MEMBER FROM MICHIGAN MEDICAL PATIENT CARE TO THE SPECTRUM HEALTH MEDICAL GROUP EFFECTIVE JANUARY 1, 2011.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITHIN THE GOVERNING BODY
FORM 990, PART VI, SECTION B, LINE 11CHERYL PIERRE (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.
AVAILABLE UPON REQUESTFORM 990, PART VI, SECTION C, LINE 19
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 XI, LINE 2C
CHERYL PIERRE IS COMPENSATED FOR HER WORK AT SPECTRUM HEALTH MEDICAL GROUP (FORMERLY MICHIGAN MEDICAL PATIENT CARE), WHICH IS A FOUNDING MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HER TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTROS JAN PLASMAN IS COMPENSATED FOR HER WORK AT SPECTRUM HEALTH MEDICAL GROUP (FORMERLY MICHIGAN MEDICAL PATIENT CARE), WHICH IS A FOUNDING MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS 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 (FORMERLY MICHIGAN MEDICAL PATIENT CARE) WHICH IS A FOUNDING MEMBER OF HOLLAND COMMUNITY HEALTH CENTER, BUT IS NOT COMPENSATED FOR HER TIME AND SERVICES PERFORMED TO THE BOARD OF DIRECTORS. CALVIN SIEGERS, M.D. IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP (FORMERLY MICHIGAN MEDICAL PATIENT CARE), 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. SAMIR RAJANI, M.D. IS COMPENSATED FOR HIS WORK AT SPECTRUM HEALTH MEDICAL GROUP (FORMERLY MICHIGAN MEDICAL PATIENT CARE), 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.FORM 990, PART VII, SECTION A, LINE 1
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 VI, SECTION B, LINE 13-14
MMPC PAYS ALL OPERATING EXPENSES OF HCHC AND IS REIMBURSED BY HCHC.FORM 990, PART VII, SECTION B, LINE 1(B)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HOLLAND COMMUNITY HOSPITALSBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1602 MICHIGAN AVENUEAddressLine1
CityHOLLANDCity
StateMIState
ZIP Code49423ZIPCode
FieldValueIRS element (for citing)
EIN382800065EIN
Primary ActivitiesHEALTH CARE NEEDS OF THE HOLLAND COMMUNITYPrimaryActivities
Legal Domicile StateMILegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MICHIGAN MEDICAL PATIENT CAREBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14100 LAKE DR SE STE 300AddressLine1
CityGRAND RAPIDSCity
StateMIState
ZIP Code49546ZIPCode
FieldValueIRS element (for citing)
EIN382851295EIN
Primary ActivityPHYSICIAN OWNED MULTI-SPECIALITY GROUP DEDICTATED TO TOTAL HEALTH CARE NEEDSPrimaryActivity
Legal Domicile StateMILegalDomicileState
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
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 Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MICHIGAN MEDICAL PATIENT CARE
L1152882COSTS PAID
MICHIGAN MEDICAL PATIENT CARE
O360125COSTS PAID
HOLLAND COMMUNITY HOSPITAL
C820789PAYMENTS RECEIVED AND DUE
HOLLAND COMMUNITY HOSPITAL
J64619RENT PAID