2021-09-14T13:29:07-05:00 2020-10-31 382806590 MAKELA TOUTANT HILL NARDI & KATONA PC 201 W BLUFF STREET MARQUETTE MI 49855 990 2019-11-01 264299275 UPPER GREAT LAKES FAMILY HEALTH CENTER UPPE 9064831705 135 EAST M-35 GWINN MI 49841 TREVOR HODGES CHIEF FINANCIAL OFFICER 9064831705 2021-09-14 1 ROBIN RAUVALA CPA P00070626 9062283600 2021-09-14 2019 2022-09-23 18:48:47Z DONALD SIMILA 135 EAST M-35 GWINN MI 49841 24315406 0 X WWW.UGLHEALTH.ORG X 2009 MI TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES FOR ALL PEOPLE IN THE UPPER GREAT LAKES REGION. 11 11 231 11 164 0 3819083 6367850 18666835 17906120 163 221 103160 41215 22589241 24315406 0 0 0 0 11543074 12857957 0 0 0 9746641 9013204 21289715 21871161 1299526 2444245 8301987 14807281 1890896 5951945 6411091 8855336 TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES FOR ALL PEOPLE IN THE UPPER GREAT LAKES REGION REGARDLESS OF ABILITY TO PAY. 0 0 19026634 17913980 THE ORGANIZATION OPERATES CLINICS IN TWELVE LOCATIONS SERVING HOUGHTON, IRON, MARQUETTE, MENOMINEE AND ONTONAGON COUNTIES. SERVICES (ONSITE AND THROUGH REFERRAL) INCLUDE PRIMARY CARE, ORAL HEALTH CARE AND BEHAVIORAL HEALTH SERVICES, SUBSTANCE ABUSE COUNSELING, ENABLING SERVICES, SPECIALTY CARE/SERVICES, EDUCATION AND COMPREHENSIVE OUTREACH. DURING THE TAX YEAR, THE ORGANIZATION HAD 81,996 PATIENT VISITS. 19026634 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 28 0 1 231 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MI X TREVOR HODGES 9064831846 56901 S 6TH STREET SUITE 1 2 CALUMET MI 49913 CATHRYN BEER CHAIR (PRESIDENT) 1.50 X X 0 0 0 STEPHEN VAIRO VICE CHAIR 1.50 X X 0 0 0 LARRY ZIOMKOWSKI SECRETARY 1.50 X X 0 0 0 FR ALLEN MOTT TREASURER 1.50 X X 0 0 0 DIANNA CHRISTENSON TRUSTEE 1.50 X 0 0 0 CHRISTOPHER ADAMS TRUSTEE 1.50 X 0 0 0 COLLENE FROBERG-EDEN TRUSTEE 1.50 X 0 0 0 GUY HEMBROFF TRUSTEE 1.50 X 0 0 0 MICAH STIPECH TRUSTEE 1.50 X 0 0 0 KEVIN PIGGOTT TRUSTEE 1.50 X 0 0 0 JULIE SHAW TRUSTEE 1.50 X 0 0 0 DONALD SIMILA CHIEF EXECUTIVE OFFICER 40.00 X 282720 0 15945 BRIAN DONAHUE CHIEF FINANCIAL OFFICER (PART YEAR) 40.00 X 158416 0 22949 TREVOR HODGES CHIEF FINANCIAL OFFICER (PART YEAR) 40.00 X 90474 0 21783 CATHERINE KROLL CHIEF MEDICAL OFFICER 40.00 X 281967 0 23955 BRUCE TRUSOCK MEDICAL DIRECTOR 40.00 X 247948 0 19609 SHERYL PARKS PHYSICIAN 40.00 X 311536 0 26311 MICHAEL YARD PHYSICIAN 40.00 X 231279 0 13098 JESSE HEARD PHYSICIAN 40.00 X 210694 0 12568 JOE-LA DEWITT PHYSICIAN 40.00 X 331205 0 27476 DAVID KASS PHYSICIAN 40.00 X 232281 0 22496 2378520 0 206190 17 0 1 0 UP HEALTH SYSTEM - PORTAGE 500 CAMPUS DRIVE HANCOCK MI 49930 LEASED EMPLOYEES AND SERVICES 3552068 E CLINICAL WORKS LLC TWO TECHNOLOGY DRIVE WESTBOROUGH MA 01581 RECORDS MANAGEMENT 352435 MICHIGAN PRIMARY CARE ASSOC PO BOX 771344 CHICAGO IL 60677 NETWORK HOSTING 206029 COMP HEALTH PO BOX 972651 DALLAS TX 75397 MEDICAL LOCUM TENENS 178483 WELLBOX INC 4401 SALISBURY ROAD 104 JACKSONVILLE FL 32216 CARE MANAGEMENT 101594 5 6230574 137276 6367850 PHYSICIAN SERVICES 621110 13294710 13294710 340B DRUG PRICING PROGRAM 621110 3732793 3732793 INCENTIVE PROGRAM PAYMENTS 621110 593902 593902 VACCINE PROGRAM 621110 136541 136541 MI CARE PROGRAM 621110 124226 124226 23948 23948 17906120 221 221 26319 0 26319 26319 164 26155 MEDICAL RECORDS FEES 561439 7860 7860 MISCELLANEOUS 900099 7036 7036 14896 24315406 17913980 164 33412 X 1078984 523634 555350 9327939 8180651 1147288 248774 217393 31381 1489319 1342245 147074 712941 623008 89933 27989 27989 21647 21647 4139813 3861999 277814 173115 133555 39560 181520 91815 89705 1025976 846097 179879 989236 866430 122806 45375 38115 7260 53735 43815 9920 13954 10765 3189 291205 252864 38341 99857 77038 22819 MEDICAL SUPPLIES/EQUIP 1398705 1390100 8605 BAD DEBTS 351440 351440 340B DRUG PROGRAM COSTS 92723 92723 LICENSES/DUES 61851 47717 14134 45063 35230 9833 21871161 19026634 2844527 0 1885748 6304485 384258 2698666 3131980 2826025 144849 146609 129746 278609 3476029 1250354 2254017 2225675 371389 327212 8301987 14807281 1563862 3277966 31019 60132 296015 246047 0 2367800 1890896 5951945 X 6411091 8855336 6411091 8855336 8301987 14807281 2444245 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 144900 144900 1571245 87091 1484154 1724293 1163263 561030 35591 35591 2225675 PAYCHECK PROTECTION PROGRAM LOAN 2367800 2367800 X 23871243 0 23871243 444163 444163 24315406 21426998 0 21426998 444163 444163 21871161 PART X, LINE 2: UPPER GREAT LAKES IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS ALSO EXEMPT FROM SIMILAR STATE AND LOCAL TAXES. UPPER GREAT LAKES FILES FORM 990 WITH THE INTERNAL REVENUE SERVICE. UPPER GREAT LAKES BELIEVES THAT ITS INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON UPPER GREAT LAKES' FINANCIAL CONDITION, RESULTS OF OPERATIONS, OR CASH FLOWS. PART XI, LINE 4B - OTHER ADJUSTMENTS: AUDITED FINANCIAL STATEMENTS REPORT DRUG PRICING PROGRAM REVNUE NET OF COSTS 92,723. AUDITED FINANCIAL STATEMENTS REPORT PATIENT FEE REVENUE NET OF BAD DEBTS 351,440. PART XII, LINE 4B - OTHER ADJUSTMENTS: AUDITED FINANCIAL STATEMENTS REPORT DRUG PRICING PROGRAM REVNUE NET OF COSTS 92,723. AUDITED FINANCIAL STATEMENTS REPORT PATIENT FEES REVENUE NET OF BAD DEBTS 351,440. X X X X 0 0 0 0 0 0 0 0 0 DONALD SIMILA CHIEF EXECUTIVE OFFICER 245066 0 25753 0 11901 0 8757 0 12090 0 303567 0 0 0 BRIAN DONAHUE CHIEF FINANCIAL OFFICER (PART YEAR) 152816 0 4713 0 887 0 4871 0 21359 0 184646 0 0 0 CATHERINE KROLL CHIEF MEDICAL OFFICER 159377 0 79234 0 43356 0 7867 0 20609 0 310443 0 0 0 BRUCE TRUSOCK MEDICAL DIRECTOR 189120 0 56717 0 2111 0 7078 0 17084 0 272110 0 0 0 SHERYL PARKS PHYSICIAN 297878 0 0 0 13658 0 6659 0 23894 0 342089 0 0 0 MICHAEL YARD PHYSICIAN 223568 0 0 0 7711 0 6768 0 11280 0 249327 0 0 0 JESSE HEARD PHYSICIAN 187763 0 19769 0 3162 0 6264 0 9782 0 226740 0 0 0 JOE-LA DEWITT PHYSICIAN 325930 0 0 0 5275 0 7235 0 23517 0 361957 0 0 0 DAVID KASS PHYSICIAN 183721 0 46634 0 1926 0 6761 0 20247 0 259289 0 0 0 NASTARA HOLDINGS LLC NASTARA HOLDINGS LLC IS OWNED BY THE SPOUSE OF A KEY EMPLOYEE 103904 BUILDING RENTAL 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. THEN A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES BEFORE IT IS FILED. IT IS ULTIMATELY SIGNED BY THE CHEIF FINANCIAL OFFICER. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMEBERS ARE REQUIRED TO ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY ACKNOWLEDGMENT AND DISCLOSURE FORM AT THE ANNUAL BOARD MEETING. ANY CONFLICTS ARE NOTED AND MONITORED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO AND OTHER OFFICERS INCLUDES A REVIEW OF CURRENT WAGE AND SALARY SURVEYS CONDUCTED BY THE MICHIGAN PRIMARY CARE ASSOCIATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE PERSONNEL COMMITTEE PRESENTS ITS RECOMMENDATIONS TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE DECISION OF WHETHER OR NOT TO RELEASE THESE DOCUMENTS IS MADE ON A CASE BY CASE BASIS IF AND WHEN THEY ARE REQUESTED. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 52,694. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,694. REVENUE CYCLE: PROGRAM SERVICE EXPENSES 327,926. MANAGEMENT AND GENERAL EXPENSES 62,462. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 390,388. HUMAN RESOURCES: PROGRAM SERVICE EXPENSES 12,676. MANAGEMENT AND GENERAL EXPENSES 2,415. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,091. MATERIAL MANAGEMENT: PROGRAM SERVICE EXPENSES 7,801. MANAGEMENT AND GENERAL EXPENSES 1,486. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,287. BILLING SERVICES: PROGRAM SERVICE EXPENSES 79,926. MANAGEMENT AND GENERAL EXPENSES 15,224. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 95,150. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 465,077. MANAGEMENT AND GENERAL EXPENSES 88,586. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 553,663. LEASED STAFF: PROGRAM SERVICE EXPENSES 1,515,582. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,515,582. LEASED MIDLEVEL: PROGRAM SERVICE EXPENSES 128,367. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 128,367. LEASED DOCTORS: PROGRAM SERVICE EXPENSES 709,514. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 709,514. LEASED STAFF BENEFITS: PROGRAM SERVICE EXPENSES 413,918. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 413,918. JANITORIAL SERVICES: PROGRAM SERVICE EXPENSES 12,820. MANAGEMENT AND GENERAL EXPENSES 2,442. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,262. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 13,145. MANAGEMENT AND GENERAL EXPENSES 2,504. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,649. LOCUMS: PROGRAM SERVICE EXPENSES 154,816. MANAGEMENT AND GENERAL EXPENSES 45,858. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 200,674. TRANSLATION SERVICES: PROGRAM SERVICE EXPENSES 2,384. MANAGEMENT AND GENERAL EXPENSES 706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,090. LINEN SERVICES: PROGRAM SERVICE EXPENSES 13,383. MANAGEMENT AND GENERAL EXPENSES 2,549. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,932. EKG SERVICES: PROGRAM SERVICE EXPENSES 4,664. MANAGEMENT AND GENERAL EXPENSES 888. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,552.