MHA HEALTH FOUNDATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MHA HEALTH FOUNDATION (EIN 38-6091188)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201141369349304654
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

FieldValueIRS element (for citing)
Timestamp2011-05-16T13:41:34-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11111 MICHIGAN AVEAddressLine1
CityEAST LANSINGCity
StateMIState
ZIP Code48823ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN386091188EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MHA HEALTH FOUNDATIONBusinessNameLine1
Business Name Line2DBA MHA CENTER FOR HEALTH RESOURCESBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMHAHNameControl
Phone5173233443Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16215 WEST ST JOSEPH HIGHWAYAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48917ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY HENRIKSENName
TitleCFOTitle
Phone5173233443Phone
Date Signed2011-05-16DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKevin E KrauseName
Phone5173326200Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY HENRIKSENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16215 WEST ST JOSEPH HIGHWAYAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48917ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7931099GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MHA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1963YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionPERFORM THE CHARITABLE AND EDUCATIONAL FUNCTIONS OF THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees24TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI31800TotalGrossUBI
Net Unrelated Business Txbl Income8857NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1834457ContributionsGrantsPriorYear
Contributions Grants Current Year5828617ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1277392ProgramServiceRevenuePriorYear
Program Service Revenue CY1962631ProgramServiceRevenueCY
Investment Income Prior Year25450InvestmentIncomePriorYear
Investment Income Current Year45001InvestmentIncomeCurrentYear
Other Revenue Prior Year1253407OtherRevenuePriorYear
Other Revenue Current Year80356OtherRevenueCurrentYear
Total Revenue Prior Year4390706TotalRevenuePriorYear
Total Revenue Current Year7916605TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year704215SalariesEtcPriorYear
Salaries Etc Current Year1034644SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3587322OtherExpensePriorYear
Other Expenses Current Year5633142OtherExpensesCurrentYear
Total Expenses Prior Year4291537TotalExpensesPriorYear
Total Expenses Current Year6667786TotalExpensesCurrentYear
Revenues Less Expenses Prior Year99169RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1248819RevenuesLessExpensesCY
Total Assets BOY5226529TotalAssetsBOY
Total Assets EOY6278981TotalAssetsEOY
Total Liabilities BOY2123187TotalLiabilitiesBOY
Total Liabilities EOY1290003TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3103342NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4988978NetAssetsOrFundBalancesEOY
Mission DescriptionPERFORM CHARITABLE AND EDUCATIONAL FUNCTIONS OF THE MICHIGAN HEALTH & HOSPITAL ASSOCIATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2492673Expense
Revenue2433835Revenue
DescriptionKEYSTONE CENTER: ITS PURPOSE IS TO PROMOTE THE DELIVERY OF QUALITY HEALTHCARE IN MICHIGAN HOSPITALS BY SHARING BEST PRACTICES BETWEEN HOSPITALS AND DRAWING ON NATIONAL EXPERTS TO EDUCATE HOSPITALS ON QUALITY AND PATIENT SAFETY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1047582Expense
Revenue1238397Revenue
DescriptionPATIENT SAFETY ORGANIZATION: ITS PURPOSE IS TO ENCOURAGE PATIENT SAFETY PRACTICES IN MICHIGAN HOSPITALS BY COLLECTING AND SHARING DATA BETWEEN HOSPITALS REGARDING SAFETY INCIDENTS IN HOSPITALS AND BEST PRACTICES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2488052Expense
Revenue2488052Revenue
DescriptionBIO-TERRORISM PROGRAM: ITS PURPOSE IS TO PREPARE MICHIGAN HOSPITALS TO TREAT MICHIGAN CITIZENS IN THE EVENT OF BIO-TERRORISM IN MICHIGAN.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense552219Expense
Revenue773804Revenue
FieldValueIRS element (for citing)
Total Of Other Program Service Exp552219TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev773804TotalOfOtherProgramServiceRev
Total Program Service Expense6580526TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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 Organizations0GrantsToOrganizations
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 Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109629NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees24NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
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
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
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 Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
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 Line1GARY HENRIKSENBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5173233443TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16215 W ST JOSEPH HIGHWAYAddressLine1
CitylANSINGCity
StateMIState
ZIP Code48917ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
NANCY M SCHLICHTING
CHAIR1.00XX000
GERSON COOPER
MEMBER1.00X000
GARRY FAJA
MEMBER1.00X000
GERALD FITZGERALD
MEMBER1.00X000
GEORGIA FOJTASEK
MEMBER1.00X000
DAVID JAHN
MEMBER1.00X000
HENRY VEENSTRA
MEMBER1.00X000
SAM WATSON
EXECUTIVE DIRECTOR, KEYSTONE40.00X137235058460X
LUCILLE SMITH
PRESIDENT, VODI40.00X112214015490X
SPENCER JOHNSON
PRESIDENT1.00X02535105316740
FieldValueIRS element (for citing)
Total Reportable Comp From Org249449TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2535105TotalReportableCompFrmRltdOrgs
Total Other Compensation390690TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ECRI Institute
5200 BUTLER PIKEPLYMOUTH MEETINGPA19462DATA SERVICES279000
LEAN TRANSFORMATIONS GROUP
2121 RAWSONVILLE RDBELLEVILLEMI48111CONSULTANTS238434
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Government Grants2499359GovernmentGrants
All Other Contributions3329258AllOtherContributions
Total Contributions5828617TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
SUBSCRIPTIONS AND OTHE90009912420581242058
SEMINAR FEES611600395287395287
ADMINISTRATIVE FEES541900325286325286
FieldValueIRS element (for citing)
Total Program Service Revenue1962631TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column45001TotalRevenueColumn
Exclusion$45,001ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events63050GrossIncomeFundraisingEvents
Fundraising Direct Expenses14494FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column48556TotalRevenueColumn
Exclusion$48,556ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
Descriptionadvertising incomeDescription
Business Code541800BusinessCode
Total Revenue Column31800TotalRevenueColumn
Unrelated Business Revenue31800UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue31800TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7916605TotalRevenueColumn
Related Or Exempt Function Income1962631RelatedOrExemptFunctionIncome
Unrelated Business Revenue31800UnrelatedBusinessRevenue
Exclusion$93,557ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total731392Total
Program Services731392ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total303252Total
Program Services303252ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total31191Total
Program Services31191ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2162681Total
Program Services2162681ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total244653Total
Program Services244653ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total17000Total
Program Services17000ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total453930Total
Program Services453930ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4761Total
Program Services4761ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total17070Total
Program Services17070ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
GRANTS IMPLEMENTATION24993592499359
ADMINISTRATIVE FEES8726087260
HONORARIA7140071400
OTHER3687536875
DUES & SUBSCRIPTIONS69626962

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6667786Total
Program Services6580526ProgramServices
Management And General87260ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1128432BOY
EOY2142333EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3108619BOY
EOY3184714EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY695416BOY
EOY822353EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis101510LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec82678LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY8980BOY
EOY18832EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1841BOY
EOY1744EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY283241BOY
EOY109005EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5226529BOY
EOY6278981EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY352227BOY
EOY306039EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY654019BOY
EOY719642EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1116941BOY
EOY264322EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2123187BOY
EOY1290003EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY63938BOY
EOY1066226EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3039404BOY
EOY3922752EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3103342BOY
EOY4988978EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5226529BOY
EOY6278981EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

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

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1MICHIGAN HEALTH & HOSPITAL ASSOCIATION (A 501(C)(6) ORGANIZATION)BusinessNameLine1
FieldValueIRS element (for citing)
EIN381458751EIN
Type Of Organization9TypeOfOrganization
Listed In Governing Doc0ListedInGoverningDoc
Supported Organization Notified0SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

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

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis101510OtherCostOrOtherBasis
Depreciation82678Depreciation
Book Value18832BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18832TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$136,225
ACCRUED COMPENSATION$104,184
ACCRUED VACATION, BENEFITS, AND PENSION$23,913
FieldValueIRS element (for citing)
Total Of Amounts264322TotalOfAmounts
Total Revenue7916605TotalRevenue
Total Expenses6667786TotalExpenses
Excess Or Deficit For Year1248819ExcessOrDeficitForYear
Other$636,817OtherAmount
Total Adjustments636817TotalAdjustments
Excess Or Deficit Per FS1885636ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8 - Other Adjustments:Identifier
ExplanationPRIOR YEAR NET ASSETS OF RESEARCH AND DEVELOPMENT RESERVE: 636817.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1links 4 health golfNameOfEvent1
Gross Receipts Event163050GrossReceiptsEvent1
Gross Revenue Event163050GrossRevenueEvent1
Rent Facility Costs Event16123RentFacilityCostsEvent1
Other Direct Expenses Event18371OtherDirectExpensesEvent1
Gross Receipts Total63050GrossReceiptsTotal
Gross Revenue Total Events63050GrossRevenueTotalEvents
Rent Facility Costs Total Events6123RentFacilityCostsTotalEvents
Other Direct Expenses Total Events8371OtherDirectExpensesTotalEvents
Direct Expense Summary Events14494DirectExpenseSummaryEvents
Net Income Summary48556NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 (2 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
SAM WATSON
119735017500000347550237050195695000
SPENCER JOHNSON
059739101633650177434902948420218980285184501774349

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4aReturnReference
ExplanationSAM WATSON - $10,198 SPENCER JOHNSON - $1,774,349Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6THE ORGANIZATION HAS MEMBERS.
Form 990, Part VI, Section A, line 7aMEMBERS ARE ELECTED BY THE MHA BOARD (FOUNDATION'S ONLY MEMBER).
Form 990, Part VI, Section B, line 11FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING/AUDIT FIRM, AND REVIEWED BY THE CONTROLLER, CFO, AND PRESIDIENT PRIOR TO FILING.
Form 990, Part VI, Section B, line 12cREQUIRE BOARD MEMBERS TO SIGN CONFLICT OF INTEREST STATEMENTS AND VERBALLY REMIND THEM OF THAT PERIODICALLY DURING THE YEAR. THE INDIVIDUAL BOARD MEMBER IS EXPECTED TO RAISE THE ISSUE THAT HE OR SHE MAY HAVE A CONFLICT OF INTEREST AND DESCRIBE THAT CONFLICT. THE BOARD THEN DETERMINES IN EXECUTIVE SESSION WHETHER THAT PERSON HAS A CONFLICT OF INTEREST THAT WOULD PRECLUDE THAT PERSON FROM PARTICIPATING IN THE DISCUSSION AND VOTING ON THE MATTER.
Form 990, Part VI, Section C, line 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 2C:THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MHA PATIENT SAFETY ORGANIZATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16215 W ST JOSEPH HIGHWAYAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48917ZIPCode
FieldValueIRS element (for citing)
EIN800244102EIN
Primary ActivitiesPROCESS IMPROVEMENTSPrimaryActivities
Legal Domicile StateMILegalDomicileState
Total Income1240580TotalIncome
EOY Assets1090334EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MICHIGAN HEALTH & HOSPITAL ASSOCIATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16215 W ST JOSEPH HIGHWAYAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48917ZIPCode
FieldValueIRS element (for citing)
EIN381458751EIN
Primary ActivitiesPROMOTE HEALTH CAREPrimaryActivities
Legal Domicile StateMILegalDomicileState
Exempt Code Section501(C)(6)ExemptCodeSection
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MHA SERVICE CORPORATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16215 W ST JOSEPH HIGHWAYAddressLine1
CityLANSINGCity
StateMIState
ZIP Code48917ZIPCode
FieldValueIRS element (for citing)
EIN382259766EIN
Primary ActivitySERVICE TO HOSPITALSPrimaryActivity
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 Org0GiftGrantOrCapContrToOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MICHIGAN HEALTH & HOSPITAL ASSOCIATION
J17000
MICHIGAN HEALTH & HOSPITAL ASSOCIATION
K64391
MICHIGAN HEALTH & HOSPITAL ASSOCIATION
L373595
MICHIGAN HEALTH & HOSPITAL ASSOCIATION
N87260
MHA SERVICE CORPORATION
K3890
MHA SERVICE CORPORATION
L799163
MHA PATIENT SAFETY ORGANIZATION
I-4500
MHA PATIENT SAFETY ORGANIZATION
N-106855
MHA PATIENT SAFETY ORGANIZATION
P-64280

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