2016-11-14T08:16:10-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 511 Renaissance Dr Ste 120 St Joseph MI 49085 990 2015-01-01 383082107 LAKELAND IMMEDIATE CARE CENTER LAKE 2694453874 261 M-62 CASSOPOLIS MI 49031 mary middleton Executive Director 2696840259 2016-11-09 1 KENLEY G PENNER CPA P00740260 2699828000 2015 2017-02-10 21:41:12Z cassopolis family clinic Mary Middleton 261 M-62 CASSOPOLIS MI 49031 10015304 0 X HTTP://CASSFAMILYCLINIC.ORG X 1993 MI OUR MISSION IS TO PROVIDE NECESSARY, COMPASSIONATE HEALTHCARE TO PEOPLE IN OUR COMMUNITIES 11 11 98 12 0 0 5912803 2170461 5146795 6981959 -7770 -155046 9947 464538 11061775 9461912 0 0 0 0 3946223 5257110 13766 1458 140244 2330798 3063679 6290787 8322247 4770988 1139665 11505352 12231192 1711700 1335778 9793652 10895414 Our Mission is to provide necessary, compassionate healthcare to people in our communities. 0 0 6635540 7428147 CASSOPOLIS FAMILY CLINIC PROVIDES PRIMARY MEDICAL SERVICES TO LOW INCOME PATIENTS FROM CASS AND SOUTHEAST BERRIEN COUNTIES. WE PROVIDE PREVENTIVE AND PRIMARY CARE, INCLUDING OBSTETRICS. 6635540 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 23 0 1 98 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X MEREDITH NEARY 2692624267 261 M-62 CASSOPOLIS MI 49031 Robert Feldman PRESIDENT 0.50 0.00 X X 0 0 0 George Brossman VICE PRESIDENT 0.50 0.00 X X 0 0 0 MARSHA ELLIS SECRETARY 0.50 0.00 X X 0 0 0 Karen Current BOARD MEMBER 0.50 0.00 X 0 0 0 Leon Gilliam BOARD MEMBER 0.50 0.00 X 0 0 0 Adrienne Glover BOARD MEMBER 0.50 0.00 X 0 0 0 Tracy Hertsel BOARD MEMBER 0.50 0.00 X 0 0 0 MICHAEL MCCAUSLIN BOARD MEMBER 0.50 0.00 X 0 0 0 DOLORES MCNEARY BOARD MEMBER 0.50 0.00 X 0 0 0 DWAINE WARREN BOARD MEMBER 0.50 0.00 X 0 0 0 RAY CRUSE BOARD MEMBER 0.50 0.00 X 0 0 0 Laurie Fleming BOARD MEMBER - PART YEAR 0.00 0.00 X 0 0 0 MARY MIDDLETON EXECUTIVE DIRECTOR 40.00 0.00 X 144689 0 8142 MEREDITH NEARY CHIEF FINANCIAL OFFICER 40.00 0.00 X 83387 0 6485 DR NEIL SEE MEDICAL DIRECTOR 40.00 0.00 X 234865 0 15776 DR ANN TRAYNOR PHYSICIAN 40.00 0.00 X 160790 0 16626 DR M TROY SAILERS PHYSICIAN 40.00 0.00 X 160240 0 16623 DR ELIZABETH WETZEL PHYSICIAN 40.00 0.00 X 172770 0 8766 DR TIA JEFFERS DENTAL DIRECTOR 40.00 0.00 X 147530 0 8249 1104271 0 80667 7 0 1 0 LAKELAND MEDICAL PRACTICES 1234 NAPIER AVE ST JOSEPH MI 49085 MEDICAL PROVIDER SERVICES 644547 MCKESSON CORPORATION 30881 SCHOOLCRAFT LIVONIA MI 48150 MEDICAL SUPPLIES 497583 2 10851 1810002 349608 95901 2170461 PATIENT SERVICE REVENUE (75% medi 621110 6150385 6150385 340B Rebate 900099 611561 611561 HEDIS PROGRAM 621110 185013 185013 CASS COUNTY MCF 621300 35000 35000 6981959 35554 35554 6585 0 6585 6585 6585 190600 -190600 -190600 -190600 0 10851 0 0 808980 362792 446188 446188 MISCELLANEOUS REVENUE 900099 11765 11765 11765 9461912 7428147 0 -136696 242703 195568 43216 3919 4125051 3323932 734509 66610 81232 65456 14464 1312 504390 406433 89812 8145 303734 244746 54083 4905 20237 20237 41445 41445 1458 1458 786361 644043 142318 73645 73645 215566 192985 22581 203405 166592 36813 225513 184699 40814 33079 27092 5987 7082 7082 37859 37859 426085 348971 77114 36617 29990 6627 MISCELLANEOUS 414244 360349 53895 DUES & SUBSCRIPTIONS 225329 184548 40781 MEDICAL SUPPLIES 190435 190435 RECRUITING EXPENSES 58018 58018 68759 11683 57076 8322247 6635540 1546463 140244 465542 1252972 1181586 1188543 221695 79835 489197 846046 116180 133464 139037 8134841 869853 7775851 7264988 1238017 1343591 11505352 12231192 463764 504668 599 599 1247337 830511 1711700 1335778 X 9466459 10805697 327193 89717 9793652 10895414 11505352 12231192 1139665 -37903 0 X X 0 1 X 1 1 1 X 879742 1054662 2418566 5912803 2170461 12436234 3929163 3713017 4697688 5146795 7790939 25277602 28613 16242 11765 56620 4808905 4767679 7144867 11075840 9973165 37770456 735723 947136 1763929 5450886 1810002 10707676 116089 116089 735723 947136 1763929 5450886 1926091 10823765 26946691 87 2162 2461 17883 42139 64732 87 2162 2461 17883 42139 64732 4808992 4769841 7147328 11093723 10015304 37835188 0.71220 0.68780 0.00170 0.00070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 44500 44500 5733033 221072 5511961 305540 39302 266238 2050268 609479 1440789 1500 1500 7264988 COST REPORT SETTLEMENT RECEIVABLE 327404 RESTRICTED CASH 1016187 1343591 9786801 -37903 362792 324889 9461912 0 9461912 8685039 362792 362792 8322247 0 8322247 Part XI, Line 2d - Other Adjustments: PHARMACY COST OF GOODS SOLD 362,792. Part XII, Line 2d - Other Adjustments: PHARMACY COST OF GOODS SOLD 362,792. X X X 0 0 0 0 0 0 0 0 0 MARY MIDDLETON EXECUTIVE DIRECTOR 133689 0 11000 0 0 0 2949 0 5193 0 152831 0 0 0 DR NEIL SEE MEDICAL DIRECTOR 175597 0 59268 0 0 0 4778 0 10998 0 250641 0 0 0 DR ANN TRAYNOR PHYSICIAN 158927 0 1863 0 0 0 3337 0 13289 0 177416 0 0 0 DR M TROY SAILERS PHYSICIAN 156630 0 3610 0 0 0 3334 0 13289 0 176863 0 0 0 DR ELIZABETH WETZEL PHYSICIAN 166645 0 6125 0 0 0 3486 0 5280 0 181536 0 0 0 DR TIA JEFFERS DENTAL DIRECTOR 132330 0 15200 0 0 0 3004 0 5245 0 155779 0 0 0 X 2 95901 FMV 0 1 0 Form 990, Part VI, Section B, line 11 FORM 990 MUST BE APPROVED BY THE BOARD PRIOR TO FILING. Form 990, Part VI, Section B, line 12c CASSOPOLIS CLINIC PROVIDES THE FORMS FROM THE PREVIOUS YEAR AT THE BOARD OF DIRECTORS MEETING. THEY INQUIRE IF THERE ARE UPDATES AND DISCUSS ANY CHANGES OR ISSUES OF CONCERN. BOARD MEMBERS SIGN/RE-SIGN THE CONFLICT OF INTEREST FORMS AT THE JANUARY BOARD MEETING. THEY MUST ABSTAIN FROM A VOTE IF THERE IS A CONFLICT OF INTEREST. THIS WAS LAST DONE DURING THE 2015 TAX YEAR. Form 990, Part VI, Section B, line 15 CASSOPOLIS CLINIC USES SALARY SURVEYS, INCLUDING MEDICAL GROUP MANAGEMENT ASSOCIATION AND GUIDESTAR FOR NON-PROFIT CEO AND OTHER OFFICERS/KEY EMPLOYEES SALARY COMPARISONS. DOCTORS AND THE EXECUTIVE DIRECTOR HAVE YEARLY CONTRACTS AND ALL PAYROLL INCREASES AND SALARY REVIEWS ARE APPROVED BY THE BOARD OF DIRECTORS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2015. Form 990, Part VI, Section C, line 19 DOCUMENTS OPEN TO PUBLIC INSPECTION ARE AVAILABLE UPON REQUEST. Form 990, Part XII, Line 2c: THERE HAS BEEN NO CHANGE FROM PRIOR YEAR.