2022-05-16T09:23:21-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2020-07-01 832236308 MSU HEALTH CARE INC MSUH 5173533143 3610 FOREST ROAD NO C LANSING MI 48910 SETH CIABOTTI CEO 5173533143 2022-05-13 1 SETH CIABOTTI 999009999 DAVID LOWENTHAL P00378651 2483522500 2022-05-13 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z NATHAN TER BEEK 3610 FOREST ROAD NO C LANSING MI 48910 115734137 0 X WWW.HEALTHCARE.MSU.EDU X 2018 MI TO IMPROVE THE HEALTH OF ALL THE COMMUNITIES WE SERVE.MSU HEALTH CARE AS THE CLINICAL ENTERPRISE OF MICHIGAN STATE UNIVERSITY'S HUMAN HEALTH COLLEGES' FOCUS IS TO PROVIDE HEALING AND CARING, FORM JOINT VENTURES AND PARTNERSHIPS AND LEVERAGE OUR EXPANSIVE CLINICAL RESEARCH AND EXPERT EDUCATIONAL STRENGTHS FOR OUR PATIENTS.WE REMAIN DEDICATED TO THE LAND-GRANT MISSION AND VALUES OF MSU, A MEMBER OF THE ASSOCIATION OF AMERICAN UNIVERSITIES AND A TOP 100 RESEARCH INSTITUTION.MSU HEALTH CARE WAS FORMED TO: - FOCUS ON HEALING AND CARING - FORM JOINT VENTURES AND PARTNERSHIPS - LEVERAGE OUR CLINICAL, RESEARCH AND EDUCATION STRENGTHS 8 0 0 0 0 0 62226 7501152 242519 104049931 32622 94600 0 4088454 337367 115734137 0 1500 0 0 0 30382044 0 0 0 1036687 86394980 1036687 116778524 -699320 -1044387 5605003 36553428 9930 7514701 5595073 29038727 X TO IMPROVE THE HEALTH OF ALL THE COMMUNITIES WE SERVE. 1 0 99410056 1500 104049931 MSU HEALTH CARE IS A 501(C)(3) NON-PROFIT CORPORATION CREATED TO BE THE CLINICAL ENTERPRISE OF MICHIGAN STATE UNIVERSITY'S COLLEGE OF HUMAN MEDICINE, COLLEGE OF NURSING AND COLLEGE OF OSTEOPATHIC MEDICINE. OUR FOCUS IS TO PROVIDE HEALING AND CARING, FORM JOINT VENTURES AND PARTNERSHIPS AND LEVERAGE OUR EXPANSIVE CLINICAL RESEARCH AND EXPERT EDUCATIONAL STRENGTHS FOR OUR PATIENTS. WE REMAIN DEDICATED TO THE LAND-GRANT MISSION AND VALUES OF MSU, A MEMBER OF THE ASSOCIATION OF AMERICAN UNIVERSITIES AND A TOP 100 RESEARCH INSTITUTION. 99410056 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 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 1 0 0 0 1 24 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 1 1 MI X NATHAN TER BEEK 5173533143 3610 FOREST ROAD NO C LANSING MI 48910 ANTHONY AVELLINO DIRECTOR 0.25 59.75 X 0 852074 64235 NORMAN J BEAUCHAMP JR CHAIR 0.25 59.75 X X 0 699545 62833 ANDREW ZWYGHUIZEN DIRECTOR (PART YEAR) 0.25 59.75 X 0 514984 54788 ANDREA AMALFITANO VICE CHAIR 0.25 59.75 X X 0 487831 55642 ARON SOUSA DIRECTOR 0.25 59.75 X 0 419826 54853 JOEL GREENBERG TREASURER 0.25 59.75 X X 0 418070 44220 FRANCESCA C DWAMENA DIRECTOR (PART YEAR) 0.25 59.75 X 0 407890 50555 SETH CIABOTTI CEO, MSU HEALTH CARE INC 60.00 0.00 X X 343050 0 51431 JED G MAGEN DIRECTOR 0.25 59.75 X 0 308482 49495 RANDOLPH F RASCH SECRETARY 0.25 59.75 X X 0 295091 39971 ANNETTE CAWLEY CFO, MSU HEALTH CARE INC 60.00 0.00 X 212700 0 47566 KRISTINE ALLEN CHIEF NURSING OFFICER 50.00 0.00 X 203349 0 47604 DENISE K FERRELL DIRECTOR (PART YEAR) 0.25 59.75 X 0 179065 29959 COLLEEN HOFFMAN RADIOLOGY ADMINISTRATOR 40.00 0.00 X 147049 0 42870 SANDRA CAMPBELL CHIEF PHARMACIST 40.00 0.00 X 140960 0 24869 SUSAN DOLBY QUALITY/RISK MGMT ADMINISTRATOR 40.00 0.00 X 118208 0 35368 HOLLY PETERSON RADIOLOGY ADMINISTRATOR 40.00 0.00 X 114203 0 37662 CHRISTIE DAISS PHARMACIST 40.00 0.00 X 113115 0 27615 ANN SHEENHAN DIRECTOR (PART YEAR) 0.25 59.75 X 0 96460 28230 1392634 4679318 849766 0 0 1 0 CHARTIS GROUP DEPARTMENT 5925 CAROL STREAM IL 60122 STRATEGIC PLANNING 1404257 JENNIFER LYNN UITVLUGT 4760 NAKOMA DR OKEMOS MI 48864 ER PHYSICIAN 201300 LOCUM TENENSCOM LLC 2655 NORTHWEST PARKWAY ALPHARETTA GA 30009 TEMP PROVIDER COVERAGE 160861 HALL RENDER KILLIAN HEATH & LYMAN PO BOX 714570 CINCINNATTI OH 45271 LEGAL SERVICES 147657 AFIA INC 555 BRIARWOOD CIRCLE STE 116 ANN ARBOR MI 48108 CONSULTING 141669 7 7235117 175000 91035 7501152 PATIENT SERVICES 621110 71826077 71826077 CONTRACT FEES 621110 16721345 16721345 PHARMACY REVENUE 621110 14869977 14869977 SPARTAN RADIOLOGY JV INCOME 621110 487547 487547 CARE COORDINATION FEES 621110 128287 128287 16698 16698 104049931 94600 94600 680956 680956 200295 0 200295 200295 200295 PAY FOR PERFORMANCE 621110 1776180 1776180 MANAGEMENT SERVICE FEES 621110 889243 889243 BILLING SERVICE FEES 621110 216361 216361 325419 325419 3207203 115734137 104049931 0 4183054 1500 1500 917364 917364 20041370 15576537 4464833 1815250 1424550 390700 6084704 4977475 1107229 1523356 1178045 345311 156197 156197 66411 66411 2672374 1206597 1465777 172398 7401 164997 3518670 3312724 205946 6528083 300644 6227439 2848562 2575859 272703 9104 7231 1873 16785 4788 11997 47774487 47774487 1334259 30191 1304068 1902364 1810896 91468 MEDICAL SUPPLIES 16385390 16385340 50 BAD DEBT EXPENSE 1928161 1928161 MAINTENANCE 351603 310735 40868 DUES & SUBSCRIPTIONS 64620 46712 17908 665512 550183 115329 116778524 99410056 17368468 0 705261 1484628 4174742 22376492 9712933 776318 2605797 1333622 0 1272175 725000 930882 5605003 36553428 9930 1985267 124720 0 5404714 9930 7514701 X 5595073 29038727 5595073 29038727 5605003 36553428 X -1044387 -528082 25016123 X 0 1 X 1 0 X 6500000 62226 7501152 14063378 242519 104049931 104292450 6500000 304745 111551083 118355828 6500000 7235117 13735117 237519 16051551 16289070 6500000 237519 23286668 30024187 88331641 2120 0 975851 977971 2120 975851 977971 3207203 3207203 6502120 304745 115734137 122541002 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 248303 23084 225219 1277520 364300 913220 1079974 946238 133736 1272175 DUE TO RELATED PARTY 5404714 5404714 94188514 -21545623 -21545623 115734137 0 115734137 70216778 0 70216778 46561746 46561746 116778524 PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -1,928,161. GAIN ON TRANSFER OF OPERATIONS 25,016,123. EXPENSES NETTED WITH REVENUE FOR FS REPORTING -44,633,585. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,928,161. EXPENSES NETTED WITH REVENUE FOR FS REPORTING 44,633,585. X 0 0 0 0 0 0 0 0 0 ANTHONY AVELLINO DIRECTOR 0 471360 0 145000 0 235714 0 27690 0 36545 0 916309 0 0 NORMAN J BEAUCHAMP JR CHAIR 0 594105 0 100000 0 5440 0 28500 0 34333 0 762378 0 0 ANDREW ZWYGHUIZEN DIRECTOR (PART YEAR) 0 92863 0 167621 0 254500 0 23131 0 31657 0 569772 0 0 ANDREA AMALFITANO VICE CHAIR 0 391906 0 95925 0 0 0 24378 0 31264 0 543473 0 0 ARON SOUSA DIRECTOR 0 309826 0 20000 0 90000 0 24575 0 30278 0 474679 0 0 JOEL GREENBERG TREASURER 0 183476 0 234594 0 0 0 13968 0 30252 0 462290 0 0 FRANCESCA C DWAMENA DIRECTOR (PART YEAR) 0 240362 0 85165 0 82363 0 23131 0 27424 0 458445 0 0 SETH CIABOTTI CEO, MSU HEALTH CARE INC 310550 0 32500 0 0 0 22267 0 29164 0 394481 0 0 0 JED G MAGEN DIRECTOR 0 220500 0 37982 0 50000 0 28364 0 21131 0 357977 0 0 RANDOLPH F RASCH SECRETARY 0 288496 0 0 0 6595 0 16862 0 23109 0 335062 0 0 ANNETTE CAWLEY CFO, MSU HEALTH CARE INC 212225 0 0 0 475 0 21416 0 26150 0 260266 0 0 0 KRISTINE ALLEN CHIEF NURSING OFFICER 203349 0 0 0 0 0 20571 0 27033 0 250953 0 0 0 DENISE K FERRELL DIRECTOR (PART YEAR) 0 154412 0 0 0 24653 0 12622 0 17337 0 209024 0 0 COLLEEN HOFFMAN RADIOLOGY ADMINISTRATOR 146669 0 0 0 380 0 14707 0 28163 0 189919 0 0 0 SANDRA CAMPBELL CHIEF PHARMACIST 139980 0 0 0 980 0 14288 0 10581 0 165829 0 0 0 SUSAN DOLBY QUALITY/RISK MGMT ADMINISTRATOR 117923 0 0 0 285 0 11806 0 23562 0 153576 0 0 0 HOLLY PETERSON RADIOLOGY ADMINISTRATOR 113918 0 0 0 285 0 11432 0 26230 0 151865 0 0 0 PART I, LINE 3 THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITEE FORM 990, PART III, LINE 2 IN FY21, MSU HEALTH CARE INC. BEGAN RECORDING CLINICAL OPERATIONS UNDER ITS OWN TAX ID. PREVIOUSLY THIS ACTIVITY OCCURRED UNDER A RELATED PARTY, MICHIGAN STATE UNIVERSITY. FORM 990, PART VI, SECTION A, LINE 6 THE BOARD OF TRUSTEES OF MICHIGAN STATE UNIVERSITY IS THE SOLE MEMBER OF MSU HEALTH CARE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER SHALL HAVE SUCH RIGHTS AND POWERS AS ARE PROVIDED IN THE ARTICLES, THE BYLAWS, AND THE LAWS OF THE STATE OF MICHIGAN, INCLUDING THE FOLLOWING POWERS: (A) TO AMEND THE ARTICLES AND/OR THE BYLAWS; (B) THE APPOINT OR REMOVE, WITH OR WITHOUT CASE, ANY DIRECTOR OF THE CORPORATION, AS DESCRIBED HEREIN; (C) TO VOTE ON ALL MATTERS IN WHICH THE VOTE OF MEMBERS WITH VOTING RIGHTS IS REQUIRED UNDER THE ARTICLES, THE BYLAWS, OR THE LAWS OF THE STATE OF MICHIGAN; (D) TO APPROVE THE CORPORATION'S MERGER, DISSOLUTION, CONSOLIDATED, OR REORGANIZATION; (E) TO APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER, OR OTHER ALIENATION OF THE MAJORITY OF THE CORPORATION'S ASSETS, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS; (F) TO APPROVE THE INDEBTEDNESS OF THE CORPORATION IN EXCESS OF 20% OF THE ANNUAL BUDGET OF THE CORPORATION; (G) TO APPROVE NON-BUDGETED EXPENDITURES IN EXCESS OF 10% OF THE ANNUAL BUDGET OF THE CORPORATION (H) TO APPROVE THE DISPOSITION OF THE CORPORATION'S ASSETS AS THE TIME OF THE CORPORATION'S DISSOLUTION, SUBJECT TO THE ARTICLES (I) TO APPROVE THE CORPORATION ENTERING INTO ANY JOINT VENTURES OR CREATING ANY SUBSIDIARY ORGANIZATIONS WITH A CAPITAL COMMITMENT GREATER THAN $10 MILLION DOLLARS; AND (J) TO APPROVE CHANGES IN THE CORPORATION'S MISSION OR PHILOSOPHY POWERS THAT ARE NOT RESERVED TO THE CORPORATE MEMBER OR OTHERWISE DELEGATED BY THE BOARD OF DIRECTORS SHALL BE EXERCISED BY THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE LIMITATIONS CONTAINED IN THE ARTICLES, THE BYLAWS, AND APPLICABLE LAW. AMONG SUCH POWERS, THE BOARD OF DIRECTORS SHALL HAVE AUTHORITY TO DISCUSS, VOTE UPON, AND PRESENT ANY OF THE ABOVE MATTER TO THE CORPORATE MEMBER FOR ITS APPROVAL. FORM 990, PART VI, SECTION A, LINE 7B SEE LINE 7A EXPLANATION FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ORGANIZATION'S INDEPENDENT ACCOUNTANT, REVIEWED AND APPROVED BY THE AUDIT COMMITTEE AND CFO, AND PROVIDED TO THE BOARD PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR AND PRINCIPAL OFFICER SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THE CORPORATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE INTERESTED PERSON SHALL THEN LEAVE THE BOARD OF DIRECTORS MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE CHAIRPERSON SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE, AND IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FAILURE TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST SHALL RESULT IN APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 1B THE BOARD DOES NOT HAVE ANY INDEPENDENT DIRECTORS BECAUSE THEY ARE ALL COMPENSATED BY A RELATED ORGANIZATION, BUT ULTIMATELY THE ORGANIZATION IS CONTROLLED BY THE SOLE MEMBER, ANOTHER 501(C)(3), WHICH DOES HAVE AN INDEPENDENT BOARD. PART VI, SECTION B, LINES 13 AND 14: MSU HEALTH CARE INC. DOES NOT HAVE A FORMAL WRITTEN WHISTLEBLOWER POLICY OR DOCUMENT RETENTION POLICY, BUT IS CURRENTLY USING THOSE OF MICHIGAN STATE UNIVERSITY, ITS SOLE MEMBER. THESE POLICIES ARE IN THE PROCESS OF BEING ADOPTED BY MSU HEALTH CARE INC. FORM 990, PART XI, LINE 9: GAIN ON TRANSFER OF OPERATIONS 25,016,123. MICHIGAN STATE UNIVERSITY 426 AUDITORIUM ROAD EAST LANSING MI 48824 386005984 EDUCATION MI 501(C)(3) LINE 2 N/A 0 LYSANDER SERIES OF AESIR SERIES LLC 1327 ASHLEY RIVER ROAD BLDG C STE 2 CHARLESTON SC 29407 830915942 RISK MANAGEMENT NC N/A C 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0