STRATEGY STUDIO / PUBLIC DATA EXPLORER

PACE SOUTHEAST MICHIGAN: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
PACE SOUTHEAST MICHIGAN (EIN 90-0659735)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-01
IRS object ID
202203059349301610
Schema version
2021v4.2
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)
Return2022-11-01T13:28:13-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN900659735EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PACE SOUTHEAST MICHIGANBusinessNameLine1Txt
Business Name Line2F/K/A CENTER FOR SENIOR INDEPENDENCEBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPACEBusinessNameControlTxt
Phone2485569132PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line121700 NORTHWESTERN HWY STE 900AddressLine1Txt
CitySOUTHFIELDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48075ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARY KUMMER NABERPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone2485569132PhoneNum
Signature2022-11-01SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARYPersonFirstNm
Person LastKUMMER NABERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRIAN W CARNAGHIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line124463 W TEN MILE ROADAddressLine1Txt
CitySOUTHFIELDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48033ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$125,854,350GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PACESEMI.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateMILegalDomicileStateCd
Activity Or MissionPACE SOUTHEAST MICHIGAN (PACE) IS AN ALTERNATIVE TO NURSING HOME CARE FOR THE FRAIL AND ELDERLY. THE GOAL IS TO HELP INDIVIDUALS REMAIN INDEPENDENT IN THEIR OWN HOMES AND COMMUNITIES AND TO PROVIDE RESPITE AND ASSISTANCE TO FAMILY CAREGIVERS. PACE IS A PROGRAM WHICH PROVIDES COMPREHENSIVE MEDICAL AND SUPPORTIVE SERVICES. THE INTERDISCIPLINARY TEAM AT PACE ASSESSES POTENTIAL PARTICIPANTS AND DEVELOPS A PERSON-CENTERED CARE PLAN - CUSTOMIZING SERVICES TO MEET INDIVIDUALS' NEEDS. FREQUENT CONTACTS WITH PARTICIPANTS AND REGULAR REVIEWS OF THE CARE PLAN ENSURE THAT PARTICIPANTS' NEEDS ARE BEING MET. PACE SEEKS TO FORM A PARTNERSHIP WITH THE PARTICIPANT AND CAREGIVERS TO PROMOTE INDEPENDENCE AND QUALITY OF LIFE.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee760TotalEmployeeCnt
Total Volunteers31TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,181,916PYContributionsGrantsAmt
CY Contributions Grants$114,626CYContributionsGrantsAmt
PY Program Service Revenue$111,764,342PYProgramServiceRevenueAmt
CY Program Service Revenue$124,942,786CYProgramServiceRevenueAmt
PY Investment Income$9,471PYInvestmentIncomeAmt
CY Investment Income-$145,110CYInvestmentIncomeAmt
PY Other Revenue$159,387PYOtherRevenueAmt
CY Other Revenue$112,772CYOtherRevenueAmt
PY Total Revenue$113,115,116PYTotalRevenueAmt
CY Total Revenue$125,025,074CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,697,175PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$38,879,515CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$71,400,249PYOtherExpensesAmt
CY Other Expenses$86,624,910CYOtherExpensesAmt
PY Total Expenses$106,097,424PYTotalExpensesAmt
CY Total Expenses$125,504,425CYTotalExpensesAmt
PY Revenues Less Expenses$7,017,692PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$479,351CYRevenuesLessExpensesAmt
Total Assets BOY$30,503,880TotalAssetsBOYAmt
Total Assets EOY$30,594,082TotalAssetsEOYAmt
Total Liabilities BOY$11,088,135TotalLiabilitiesBOYAmt
Total Liabilities EOY$13,169,028TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$19,415,745NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$17,425,054NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPACE SOUTHEAST MICHIGAN PROVIDES AN ALTERNATIVE TO NURSING HOME CARE FOR FRAIL, ELDERLY PEOPLE. BY BRINGING TOGETHER ALL THE CARE NEEDED, PARTICIPANTS ARE ABLE TO REMAIN INDEPENDENT IN THEIR OWN HOMES AND COMMUNITIES. PATIENTS AND THEIR CAREGIVERS ALSO ARE PROVIDED RESPITE CARE. THE COMPREHENSIVE CARE, BOTH MEDICAL AND SOCIAL ARE PROVIDED AT THE CENTER AND THE ELDER'S HOME, AS WELL AS IN THE HOSPITAL OR NURSING HOME, WHEN NECESSARY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$111,283,262ExpenseAmt
Revenue$124,909,197RevenueAmt
DescPROVIDE COMPREHENSIVE CARE TO THE FRAIL ELDERLY POPULATION UNDER PACE (THE PROGRAM FOR ALL INCLUSIVE CARE). PROVIDE EDUCATION TO THE COMMUNITY ON CARE FOR THE FRAIL ELDERLY POPULATION.Desc
Total Program Service Expenses$111,283,262TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1955IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee760EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JEFF BURMEISTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2485569132PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line121700 NORTHWESTERN HWY STE 900AddressLine1Txt
CitySOUTHFIELDCityNm
State AbbreviationMIStateAbbreviationCd
ZIP48075ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MARY KUMMER NABER
PRESIDENT/TRUSTEE40.000.00Yes (X)Yes (X)$364,667$0$26,761
BRIAN W CARNAGHI
TREASURER/TRUSTEE1.000.00Yes (X)Yes (X)$0$0$0
J DOUGLAS CLARK
TRUSTEE1.000.00Yes (X)$0$0$0
SUSAN S HAWKINS
TRUSTEE1.000.00Yes (X)$0$0$0
STEVEN G DOLUNT
TRUSTEE1.000.00Yes (X)$0$0$0
ROGER L MYERS
TRUSTEE- CHAIR1.000.00Yes (X)Yes (X)$0$0$0
DAVID F SHEPHERD
TRUSTEE- VICE CHAIR1.000.00Yes (X)Yes (X)$0$0$0
KATRINA R SUMMERSETT RN
TRUSTEE1.000.00Yes (X)$0$0$0
MANU K MALHOTRA MD
TRUSTEE1.000.00Yes (X)$0$0$0
BRENDA L LAWRENCE
TRUSTEE1.000.00Yes (X)$0$0$0
MARJORIE A STATEN JD
ASSISTANT SECRETARY1.000.00Yes (X)$0$0$0
MICHELLE JOHNSON TIDJANI ESQ
SECRETARY1.000.00Yes (X)$0$0$0
JEFFREY G BURMEISTER
C.F.O40.000.00$263,267$0$27,174Yes (X)
RENDA DAWUD
PHYSICIAN IN CHARGE40.000.00$209,622$0$34,413Yes (X)
BARUCH KATZ MD
PHYSICIAN40.000.00$238,573$0$30,803Yes (X)
RUDOLPH E MENCHL
MEDICAL DIRECTOR40.000.00$186,707$0$14,863Yes (X)
SHOAIB A RASHEED
PHYSICIAN40.000.00$192,800$0$29,016Yes (X)
DONNA M EMCH
VP PARTICIPANT CARE40.000.00$178,870$0$24,827Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,634,506TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$187,857TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K32IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HENRY FORD HEALTH SYSTEM
PO BOX 670884DETROITMI48267MEDICAL SERVICES$29,506,355
HEALTH ALLIANCE PLAN
PO BOX 55000 DEPT 271101DETROITMI48225HEALTH INSURANCE SERVICES$4,067,718
HENRY FORD MACOMB HOSPITAL
PO BOX 670884DETROITMI482670884MEDICAL SERVICES$3,624,560
TABULARASA
228 STRAWBRIDGE DRIVE SUITE 100MORRESTOWNNJ08057CONTRACTED SERVICES AND SOFTWARE$1,668,834
ENTERPRISE FM TRUST
PO BOX 800089KANSAS CITYMO64180VEHICLE LEASES AND MAINTENANCE$1,632,095
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K44CntrctRcvdGreaterThan100KCnt
All Other Contributions$114,626AllOtherContributionsAmt
Total Contributions$114,626TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICE FEESDesc
Business623000BusinessCd
Total Revenue Column$124,942,786TotalRevenueColumnAmt
Related Or Exempt Func Income$124,942,786RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$124,942,786TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,251TotalRevenueColumnAmt
Exclusion$1,251ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$682,915OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$829,276OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$146,361OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$146,361TotalRevenueColumnAmt
Related Or Exempt Func Income-$146,361RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$112,772TotalRevenueColumnAmt
Related Or Exempt Func Income$112,772RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$112,772OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$125,025,074TotalRevenueColumnAmt
Related Or Exempt Func Income$124,909,197RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,251ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$368,446TotalAmt
Program Services$350,024ProgramServicesAmt
Management And General$18,422ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$287,348TotalAmt
Program Services$272,981ProgramServicesAmt
Management And General$14,367ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,694,370TotalAmt
Program Services$26,217,797ProgramServicesAmt
Management And General$4,476,573ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$975,010TotalAmt
Program Services$834,766ProgramServicesAmt
Management And General$140,244ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,356,828TotalAmt
Program Services$3,730,148ProgramServicesAmt
Management And General$626,680ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,197,513TotalAmt
Program Services$1,881,426ProgramServicesAmt
Management And General$316,087ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,050TotalAmt
Management And General$25,050ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$57,434,818TotalAmt
Program Services$55,824,832ProgramServicesAmt
Management And General$1,609,986ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$17,400TotalAmt
Program Services$17,268ProgramServicesAmt
Management And General$132ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,200,597TotalAmt
Program Services$3,758,281ProgramServicesAmt
Management And General$3,442,316ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$848,334TotalAmt
Program Services$58,251ProgramServicesAmt
Management And General$790,083ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$558,420TotalAmt
Program Services$1,466ProgramServicesAmt
Management And General$556,954ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$354,149TotalAmt
Program Services$336,396ProgramServicesAmt
Management And General$17,753ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$140,043TotalAmt
Program Services$74,932ProgramServicesAmt
Management And General$65,111ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$989,130TotalAmt
Program Services$382,637ProgramServicesAmt
Management And General$606,493ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,449,590TotalAmt
Program Services$1,022,424ProgramServicesAmt
Management And General$427,166ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PHARMACEUTICAL SUPPLIES$15,340,148$15,340,148
REPAIRS AND MAINTENANCE$927,493$327,535$599,958
MEDICAL SUPPLIES$574,278$548,040$26,238
EMPLOYEE RECRUITING COS$193,961$133,582$60,379

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$571,499TotalAmt
Program Services$170,328ProgramServicesAmt
Management And General$401,171ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$125,504,425TotalAmt
Program Services$111,283,262ProgramServicesAmt
Management And General$14,221,163ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$17,919,287BOYAmt
EOY$15,980,498EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,020,906BOYAmt
EOY$2,763,794EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$838,615BOYAmt
EOY$1,433,772EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,246,424LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,133,759LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,206,345BOYAmt
EOY$8,112,665EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,076,038BOYAmt
EOY$1,076,038EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,442,689BOYAmt
EOY$1,227,315EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$30,503,880BOYAmt
EOY$30,594,082EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,454,336BOYAmt
EOY$2,057,431EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,633,799BOYAmt
EOY$11,111,597EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,088,135BOYAmt
EOY$13,169,028EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$19,355,246BOYAmt
EOY$17,375,895EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$60,499BOYAmt
EOY$49,159EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,415,745BOYAmt
EOY$17,425,054EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$30,503,880BOYAmt
EOY$30,594,082EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$479,351ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1,511,340OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$144,098CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$140,399CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$701,525CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,181,916CurrentTaxYearMinus1YearAmt
Current Tax Year$104,626CurrentTaxYearAmt
Total$2,272,564TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$49,192,743CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$62,961,529CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$84,086,228CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$111,923,729CurrentTaxYearMinus1YearAmt
Current Tax Year$125,065,558CurrentTaxYearAmt
Total$433,229,787TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$49,336,841CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$63,101,928CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$84,787,753CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$113,105,645CurrentTaxYearMinus1YearAmt
Current Tax Year$125,170,184CurrentTaxYearAmt
Total$435,502,351TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$435,502,351PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$49,336,841CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$63,101,928CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$84,787,753CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$113,105,645CurrentTaxYearMinus1YearAmt
Current Tax Year$125,170,184CurrentTaxYearAmt
Total$435,502,351TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,657,887OtherCostOrOtherBasisAmt
Depreciation$1,195,608DepreciationAmt
Book Value$3,462,279BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,147,170OtherCostOrOtherBasisAmt
Depreciation$2,938,151DepreciationAmt
Book Value$3,209,019BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,441,367OtherCostOrOtherBasisAmt
Book Value$1,441,367BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,112,665TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ACCRUED COMPENSATION AND RELATED LIABILITIES$1,559,325
ACCRUED EXPENSES$9,552,272
FieldValueIRS element (for citing)
Total Liability$11,111,597TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$125,735,123TotalRevEtcAuditedFinclStmtAmt
Other Revenue$710,049OtherRevenueAmt
Revenue Not Reported$710,049RevenueNotReportedAmt
Revenue Subtotal$125,025,074RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$125,025,074TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$126,214,474TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$710,049OtherExpensesIncludedAmt
Expenses Not Reported$710,049ExpensesNotReportedAmt
Expenses Subtotal$125,504,425ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$125,504,425TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:SUPPLY REBATES RECLASSIFIED TO EXPENSE 563,688. DISPOSAL OF ASSETS 146,361.
PART XII, LINE 2D - OTHER ADJUSTMENTS:SUPPLY REBATES RECORDED AS EXPENSE ON 990 AS REVENUE ON 563,688. AUDITED FINANCIAL STATEMENTS. DISPOSAL OF ASSETS 146,361.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARY KUMMER NABER
PRESIDENT/TRUSTEE$283,875$0$75,600$0$5,192$0$8,630$0$18,131$0$391,428$0$0$0
JEFFREY G BURMEISTER
C.F.O$222,467$0$40,800$0$0$0$9,043$0$18,131$0$290,441$0$0$0
BARUCH KATZ MD
PHYSICIAN$210,549$0$17,776$0$10,248$0$9,108$0$21,695$0$269,376$0$0$0
RENDA DAWUD
PHYSICIAN IN CHARGE$184,872$0$14,531$0$10,219$0$8,002$0$26,411$0$244,035$0$0$0
SHOAIB A RASHEED
PHYSICIAN$181,646$0$8,727$0$2,427$0$5,746$0$23,270$0$221,816$0$0$0
DONNA M EMCH
VP PARTICIPANT CARE$160,859$0$18,011$0$0$0$6,351$0$18,476$0$203,697$0$0$0
RUDOLPH E MENCHL
MEDICAL DIRECTOR$153,494$0$21,550$0$11,663$0$1,740$0$13,123$0$201,570$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS ORGANIZED ON A MEMBERSHIP BASIS. ITS MEMBERS ARE HENRY FORD HEALTH SYSTEM (HF HEALTH) AND PRESBYTERIAN VILLAGES OF MICHIGAN (PVM).
FORM 990, PART VI, SECTION A, LINE 7AEACH MEMBER (HF HEALTH AND PVM) APPOINTS FIFTY PERCENT OF THE TRUSTEES OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BBASED ON THE ESTABLISHED RESERVE POWERS, CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE TWO MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH"). THE TAX DEPARTMENT OF HF HEALTH PREPARES THE ORGANIZATION'S FORM 990. BEFORE THE FORM 990 IS FILED, A COPY FOR REVIEW WILL BE PROVIDED TO THE TRUSTEES OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 12CIT IS THE POLICY OF THE ORGANIZATION TO PREVENT CONFLICTS OF INTEREST IN THE WORKPLACE. INDIVIDUALS SUBJECT TO THIS POLICY SHALL UPON HIRE AND ANNUALLY THEREAFTER, COMPLETE AND SIGN A COI DISCLOSURE STATEMENT AND NOTIFY COMPLIANCE OFFICER OF ANY CHANGES TO THE INFORMATION IN THE STATEMENT.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD CHAIR AND VICE CHAIR OF THE ORGANIZATION ARE CHARGED WITH APPROVAL OF THE COMPENSATION AND BENEFIT PROGRAMS FOR THE CEO, CFO AND OTHER TOP MANAGEMENT OFFICIAL. THE PROCESS INCLUDES UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTHCARE ORGANIZATIONS. FOR OTHER EMPLOYEES, THE ORGANIZATION HAS AN INTERNAL COMPENSATION COMMITTEE CONSISTING OF THE CEO, CFO AND DIRECTOR OF HUMAN RESOURCES. THEY ARE CHARGED WITH APPROVAL OF THE COMPENSATION AND BENEFIT PROGRAMS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE AND UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS.
FORM 990, PART VI, SECTION C, LINE 18IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS TAX DOCUMENTS AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION.
FORM 990, PART VI, SECTION C, LINE 19IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION.
FORM 990, PART IX, LINE 11GCONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 54,472,306. MANAGEMENT AND GENERAL EXPENSES 8,190. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,480,496. CONSULTANTS: PROGRAM SERVICE EXPENSES 1,352,526. MANAGEMENT AND GENERAL EXPENSES 1,601,796. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,954,322.
FORM 990, PART XI, LINE 9:DECREASE IN RESTRICTED NET ASSETS -11,340. CAPITAL DISTRIBUTIONS TO MEMBERS -1,500,000.