MIDMICHIGAN URGENT CARE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MIDMICHIGAN URGENT CARE (EIN 20-5064848)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201421359349301137
- Schema version
- 2012v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T07:46:33-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREWS HOOPER PAVLIK PLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5300 GRATIOT RD | AddressLine1 |
| City | SAGINAW | City |
| State | MI | State |
| ZIP Code | 486386035 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205064848 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN URGENT CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIDM | NameControl |
| Phone | 9898393181 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3009 N SAGINAW RD | AddressLine1 |
| City | MIDLAND | City |
| State | MI | State |
| ZIP Code | 48640 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | FRANCINE M PADGETT | Name |
| Title | SR. VP & TREASURER | Title |
| Phone | 9898393181 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LAURA M EBEL | Name |
| Phone | 9894975300 | Phone |
| Date Prepared | 2014-05-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES BICKNELL MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3009 N SAGINAW RD | AddressLine1 |
| City | MIDLAND | City |
| State | MI | State |
| ZIP Code | 48640 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3520134 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MIDMICHIGAN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 54 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3942031 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3400656 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 7318 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8493 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 241 | OtherRevenuePriorYear |
| Other Revenue Current Year | 90787 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3949590 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3499936 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2532641 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2781811 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1336313 | OtherExpensePriorYear |
| Other Expenses Current Year | 1065283 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3868954 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3847094 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 80636 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -347158 | RevenuesLessExpensesCY |
| Total Assets BOY | 1376227 | TotalAssetsBOY |
| Total Assets EOY | 1019267 | TotalAssetsEOY |
| Total Liabilities BOY | 335070 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 313608 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1041157 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 705659 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE EXCELLENT HEALTH SERVICES TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITIES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 3779590 | Expense |
| Revenue | 3400656 | Revenue |
| Description | TO PROVIDE ACCESS TO AMBULATORY HEALTHCARE SERVICES TO MIDLAND COUNTY AND THE SURROUNDING REGION REGARDLESS OF ABILITY TO PAY. PATIENT VISITS FOR CURRENT YEAR: 39,089 | Description |
| Total Program Service Expense | 3779590 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 54 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | FM PADGETT SR VP TREASURER | NamePerson |
| Telephone Number | 9898393181 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4000 WELLNESS DR | AddressLine1 |
| City | MIDLAND | City |
| State | MI | State |
| ZIP Code | 48670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| RICHARD REYNOLDS | ||||||||
| DIRECTOR | 2.00 | 50.00 | X | 0 | 1490788 | 335094 | ||
| BRIAN RODGERS | ||||||||
| CHAIR | 2.00 | 50.00 | X | 0 | 307351 | 90201 | ||
| JAMES BICKNELL MD | ||||||||
| PRESIDENT | 2.00 | 50.00 | X | 0 | 281591 | 44725 | X | |
| WILLIAM DERY MD | ||||||||
| VICE CHAIR | 2.00 | 50.00 | X | 0 | 266721 | 82461 | X | |
| DANIEL SORENSON MD | ||||||||
| DIRECTOR | 2.00 | 50.00 | X | 0 | 199313 | 40945 | ||
| DIANE POSTLER-SLATTERY | ||||||||
| PRESIDENT | 2.00 | 50.00 | X | 0 | 48183 | 0 | X | |
| ANN FILLMORE | ||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| CHUCK KENDALL | ||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| DAN KOZAKIEWICZ | ||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| JAN MCGUIRE | ||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| JEFF NEWMAN MD | ||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| MIKE WOODY | ||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| FRANCINE PADGETT | ||||||||
| SEC/TREAS | 2.00 | 50.00 | 0 | 354655 | 108431 | X | ||
| DOUGLAS MIKOLS MD | ||||||||
| PHYSICIAN | 50.00 | 0.00 | 222419 | 0 | 26513 | X | ||
| JAMIE POLISKEY MD | ||||||||
| PHYSICIAN | 50.00 | 217575 | 0 | 26572 | X | |||
| SHRADDHA PATEL MD | ||||||||
| PHYSICIAN | 50.00 | 0.00 | 122448 | 0 | 0 | X | ||
| THOMAS SHERWOOD MD | ||||||||
| PHYSICIAN | 50.00 | 0.00 | 103257 | 0 | 11158 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 665699 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2948602 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 766100 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEATHERBY LOCUMS INC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 972633 | AddressLine1 |
| City | DALLAS | City |
| State | TX | State |
| ZIP Code | 75397 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | PHYSICIAN LOCUM | DescriptionOfServices |
| Compensation | 118364 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 621990 | 2580748 | 2580748 |
| MEDICARE/MEDICAID PAYMENTS | 621990 | 773275 | 773275 |
| CONTRACTED CLINICAL SERVICES | 621110 | 46633 | 46633 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3400656 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2422 | TotalRevenueColumn |
| Exclusion | $2,422 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 26269 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 20198 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6071 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6071 | TotalRevenueColumn |
| Exclusion | $6,071 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 90787 | TotalRevenueColumn |
| Related Or Exempt Function Income | 90787 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 90787 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3499936 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3491443 | RelatedOrExemptFunctionIncome |
| Exclusion | $8,493 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2425986 | Total |
| Program Services | 2374003 | ProgramServices |
| Management And General | 51983 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78773 | Total |
| Program Services | 77694 | ProgramServices |
| Management And General | 1079 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121885 | Total |
| Program Services | 116393 | ProgramServices |
| Management And General | 5492 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155167 | Total |
| Program Services | 151305 | ProgramServices |
| Management And General | 3862 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1771 | Total |
| Program Services | 1771 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 474 | Total |
| Program Services | 474 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 643338 | Total |
| Program Services | 643338 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1280 | Total |
| Program Services | 1280 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49204 | Total |
| Program Services | 44116 | ProgramServices |
| Management And General | 5088 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20905 | Total |
| Program Services | 20905 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71916 | Total |
| Program Services | 71916 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2656 | Total |
| Program Services | 2656 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19979 | Total |
| Program Services | 19979 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88375 | Total |
| Program Services | 88375 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2670 | Total |
| Program Services | 2670 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| UNCOMPENSATED SERVICES | 121838 | 121838 |
| MEDICAL SUPPLIES | 40877 | 40877 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3847094 | Total |
| Program Services | 3779590 | ProgramServices |
| Management And General | 67504 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | X | InfoInScheduleOPartX |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 370 | BOY |
| EOY | -3713 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13743 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 435216 | BOY |
| EOY | 328885 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1191 | BOY |
| EOY | 146 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1379185 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 736665 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 722843 | BOY |
| EOY | 642520 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24298 | BOY |
| EOY | 8534 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178566 | BOY |
| EOY | 42895 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1376227 | BOY |
| EOY | 1019267 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 177332 | BOY |
| EOY | 191584 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 157738 | BOY |
| EOY | 122024 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 335070 | BOY |
| EOY | 313608 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1041157 | BOY |
| EOY | 705659 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1041157 | BOY |
| EOY | 705659 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1376227 | BOY |
| EOY | 1019267 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -347158 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 11660 | ReconciliationUnrealizedInvest |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2559198 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2576062 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3140976 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3942031 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3400656 | CurrentTaxYear |
| Total | 15618923 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2559198 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2576062 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3140976 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3942031 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3400656 | CurrentTaxYear |
| Total | 15618923 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 15618923 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5149 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3440 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2144 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3184 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2422 | CurrentTaxYear |
| Total | 16339 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5149 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3440 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2144 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3184 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2422 | CurrentTaxYear |
| Total | 16339 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3587 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 557 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2779 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 242 | CurrentTaxYearMinus1Year |
| Current Tax Year | 90787 | CurrentTaxYear |
| Total | 97952 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2567934 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2580059 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3145899 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3945457 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3493865 | CurrentTaxYear |
| Total | 15733214 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99270 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99720 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 901890 | OtherCostOrOtherBasis |
| Depreciation | 387046 | Depreciation |
| Book Value | 514844 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11862 | OtherCostOrOtherBasis |
| Depreciation | 1647 | Depreciation |
| Book Value | 10215 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 465433 | OtherCostOrOtherBasis |
| Depreciation | 347972 | Depreciation |
| Book Value | 117461 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 642520 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTERCOMPANY LOAN | Description |
| Amount | $122,024 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 122024 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 3511122 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 11660 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 11660 | RevenueNotRptdF990 |
| Revenue Subtotal | 3499462 | RevenueSubtotal |
| Investment Expenses Not Included | 474 | InvestmentExpensesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 474 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 3499936 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 3846620 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 3846620 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 474 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 474 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 3847094 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD REYNOLDS | ||||||||||||
| DIRECTOR | 558629 | 50000 | 882159 | 312473 | 22621 | 1825882 | 425203 | |||||
| BRIAN RODGERS | ||||||||||||
| CHAIR | 275055 | 15000 | 17296 | 72765 | 17436 | 397552 | ||||||
| JAMES BICKNELL MD | ||||||||||||
| PRESIDENT | 280080 | 1511 | 30122 | 14603 | 326316 | |||||||
| WILLIAM DERY MD | ||||||||||||
| VICE CHAIR | 258568 | 8153 | 67959 | 14502 | 349182 | |||||||
| DANIEL SORENSON MD | ||||||||||||
| DIRECTOR | 181813 | 17500 | 30456 | 10489 | 240258 | |||||||
| FRANCINE PADGETT | ||||||||||||
| SECTREAS | 305957 | 15000 | 33698 | 84095 | 24336 | 463086 | ||||||
| DOUGLAS MIKOLS MD | ||||||||||||
| PHYSICIAN | 198532 | 23887 | 11394 | 15119 | 248932 | |||||||
| JAMIE POLISKEY MD | ||||||||||||
| PHYSICIAN | 193312 | 24263 | 11189 | 15383 | 244147 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NON-FIXED PAYMENTS PROVIDED | SCHEDULE J, PAGE 1, PART I, LINE 7 | MIDMICHIGAN HEALTH'S COMPENSATION INCLUDES BOTH BASE AND VARIABLE COMPENSATION (NONFIXED PAYMENTS). IN ACCORDANCE WITH ITS POLICIES, ALL ELEMENTS (BASE, VARIABLE, BENEFITS, AND PERQUISITES) ARE COMPARED TO MARKET AND ARE DETERMINED BY THE COMPENSATION COMMITTEE AFTER A REVIEW BY AN INDEPENDENT CONSULTANT, SULLIVAN COTTER, TO ENSURE THAT TOTAL COMPENSATION REMAINS WITHIN ACCEPTABLE GUIDELINES (60% OF MEDIAN). THE COMPENSATION COMMITTEE, WHO IS AUTHORIZED TO ACT ON BEHALF OF THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS, APPROVED COMPENSATION FOR THE MIDMICHIGAN HEALTH CEO, SENIOR EXECUTIVES AND PHYSICIANS. SULLIVAN COTTER ISSUED A COMPREHENSIVE ASSESSMENT IN 2009 AND AGAIN IN 2013. IN ADDITION, AS A PART OF THE PHYSICIAN ENTERPRISE ENGAGEMENT, KAUFMAN HALL ISSUED A SAFE HARBOR LETTER THAT WAS REVIEWED AT THE JUNE 2013 COMPENSATION COMMITTEE MEETING. |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | ON MAY 8, 2009 MIDMICHIGAN HEALTH'S COMPENSATION COMMITTEE APPROVED ITS FIRST COMPENSATION COMMITTEE CHARTER AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH APPROVED BOTH THE CHARTER AND THE STRATEGY ON JUNE 8, 2009. MIDMICHIGAN HEALTH ALSO CONTINUES TO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST WITH THE GOVERNANCE PROCESS AND TO REVIEW AND REPORT ON ALL SYSTEM LEVEL EXECUTIVES, HOSPITAL LEVEL EXECUTIVES AND SELECTED OTHER EXECUTIVES. MIDMICHIGAN HEALTH HAS TAKEN A CONSERVATIVE POSTURE WITH RESPECT TO ALL PERQUISITES AND ALL PERQUISITES MUST BE JUSTIFIED BY BUSINESS NEED. MIDMICHIGAN HEALTH TARGETS THE BASE SALARY OF ITS EXECUTIVES WITHIN A MARKET COMPETITIVE SALARY RANGE WITH A MIDPOINT APPROXIMATELY EQUAL TO THE 50TH PERCENTILE OF THE BASE SALARY MARKET DATA. MARKET DATA IS OBTAINED NATIONALLY FROM HEALTH SYSTEMS, HOSPITALS AND ORGANIZATIONS OF COMPARABLE SIZE BY SULLIVAN COTTER, AN INDEPENDENT CONSULTANT. NET OPERATING REVENUE IS THE CRITICAL FACTOR UTILIZED TO DETERMINE COMPARABILITY. PART I, LINE 4B - REYNOLDS, PADGETT, RODGERS, BICKNELL AND POSTLER-SLATTERY ARE PARTICIPANTS IN A 457(F) PLAN. THE ONLY PAYMENT MADE IN 2012 WAS TO REYNOLDS WHO HAD VESTED AS OF 1/1/2012 AND RECEIVED THE AMOUNT REQUIRED TO BE PAID OUT ACCORDING TO THE PLAN. THE SERP IS UNFUNDED AND BEGAN ON JANUARY 1, 2009. THE CURRENT PARTICIPANTS OF THE PLAN ARE THOSE WHO HOLD A CORPORATE OFFICE OF VICE PRESIDENT OR ABOVE. EACH PARTICIPANTS ANNUAL AWARD IS A BENEFIT RESTORATION AMOUNT THAT PROVIDES THE ADDITIONAL BENEFITS THAT THE PARTICIPANT DID NOT EARN UNDER THE PENSION PLAN AND 403(B) PLAN DURING A PLAN YEAR BECAUSE OF THE STATUTORY LIMITS. A PARTICIPANT'S ACCOUNT SHALL BE 100% VESTED IF THE PARTICIPANT IS EMPLOYED BY MIDMICHIGAN HEALTH ON THE DATE THE FIRST OF THE FOLLOWING VESTING EVENTS OCCUR: ATTAINMENT OF NORMAL RETIREMENT AGE; DEATH; TERMINATION OF EMPLOYMENT BECAUSE OF TOTAL DISABILITY; OR, PROVIDED THEY HAVE BEEN EMPLOYED AT LEAST FIVE YEARS AND THE PARTICIPANT EARNS 75 POINTS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ADDITIONAL INFORMATION | FORM 990 | ALL LINES LEFT BLANK ARE NOT APPLICABLE TO THE ORGANIZATION |
| ADDITIONAL INFORMATION | FORM 990, PART VI | PART 1, LINES 3 & 4 AND PART VI, SECTION A, LINE 1 - THOSE MEMBERS WHO ARE NOT INDEPENDENT ARE EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION LISTED IN SCHEDULE R AND ARE COMPENSATED AT MARKET VALUE FOR THE SERVICES PROVIDED TO THAT ORGANIZATION. |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | THE ARTICLES OF INCORPORATION OF THE ORGANIZATION WERE AMENDED IN JUNE OF 2013 TO INCLUDE THE FOLLOWING LANGUAGE: THE PURPOSES OF THE CORPORATION SHALL INCLUDE PROVIDING A BENEFIT TO ITS MEMBER, AND THE CORPORATION MAY PAY DIVIDENDS OR DISTRIBUTE ITS INCOME OR PROFIT TO MIDMICHIGAN HEALTH, ITS SOLE MEMBER AND A MICHIGAN NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, PROVIDED ANY SUCH PAYMENTS OR DISTRIBUTIONS ARE OTHERWISE CONSISTENT WITH THE CORPORATION'S PURPOSES AND ARE OTHERWISE PERMITTED UNDER THE MICHIGAN NONPROFIT CORPORATION ACT, AS AMENDED. THE CORPORATION SHALL NOT TAKE ANY ACTION WHICH, IF TAKEN DIRECTLY BY MIDMICHIGAN HEALTH, WOULD REQUIRE APPROVAL OF ALL MEMBER CLASSES OF MIDMICHIGAN HEALTH, UNLESS SUCH ACTION IS APPROVED BY MIDMICHIGAN HEALTH AS THE SOLE MEMBER OF THE CORPORATION. |
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MIDMICHIGAN HEALTH. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS OF MIDMICHIGAN HEALTH, THE ORGANIZATION'S SOLE CORPORATE MEMBER, ELECTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE PURPOSES OF THE CORPORATION; B) APPROVE CHANGES IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE , OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION IN EXCESS OF ANY AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER; F) APPROVE THE GUARANTEE BY THE CORPORATION OF THE DEBT OF OTHERS; G) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION IN AN AMOUNT IN EXCESS OF AN AMOUNT DESIGNATED FROM TIME TO TIME BY THE SOLE MEMBER. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 INFORMATION IS PREPARED BY THE FINANCE STAFF AT MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THIS ORGANIZATION. THE INFORMATION IS SUBMITTED FOR REVIEW BY A SENIOR FINANCE STAFF MEMBER AT MIDMICHIGAN HEALTH. THE STAFF MEMBER IN CONSULTATION WITH OUR TAX ACCOUNTANT (A CERTIFIED PUBLIC ACCOUNTING FIRM) REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. ONCE THE INITIAL REVIEW IS COMPLETE, THE INFORMATION IS SUBMITTED TO OUR TAX PROFESSIONALS AT ANDREWS HOOPER PAVLIK PLC. UPON REVIEW BY THEIR PROFESSIONALS, INCLUDING A PARTNER, INFORMATION IS RETURNED TO MIDMICHIGAN HEALTH FOR ITS FINAL REVIEW. THIS REVIEW INCLUDES A REVIEW BY THE SVP AND TREASURER. ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MIDMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE PRIOR TO FILING. FORM 990, INCLUDING ALL SCHEDULES, IS MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND TREASURER. THE QUESTIONS OR CONCERNS OF THESE REVIEWS ARE PRESENTED TO THE MIDMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS, IF ANY ARE IDENTIFIED. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE, AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1) TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2) TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; 3) AND TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MIDMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES ARE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT INDEPENDENT. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | ALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY APPROVED BY AN INDEPENDENT COMPENSATION COMMITTEE OF MIDMICHIGAN HEALTH AND THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | ALL OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE FOR ADHERENCE TO CORPORATE POLICIES. FOR DETAILED INFORMATION ON COMPENSATION, PLEASE SEE SCHEDULE J. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | NO DIRECTORS RECEIVE PAY FOR THE PURPOSE OF SERVING ON THE BOARD. THEY ARE CONSIDERED TO WORK AN AVERAGE OF 2 HOURS A WEEK ON BOARD-RELATED MATTERS. ALL INDIVIDUALS WITH REPORTABLE COMPENSATION ARE PAID BY EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION FOR SERVICES RELATED TO A FULL-TIME POSITION. THOSE PERSONS ARE ESTIMATED TO WORK AN AVERAGE OF 50 HOURS A WEEK RELATED TO THEIR FULL-TIME POSITION. OFFICERS PAID BY A RELATED ORGANIZATION ARE EMPLOYEES OF MIDMICHIGAN HEALTH, THE SOLE MEMBER OF THE CORPORATION. MIDMICHIGAN HEALTH PROVIDES MANAGERIAL ASSISTANCE TO ITS VARIOUS SUBSIDIARIES AND HOURS OF SERVICES IS NOT TRACKED BY AFFILIATE. THEREFORE THE FULL TIME SERVICE TO ALL AFFILIATES OF 50 HOURS PER WEEK IS LISTED FOR THOSE OFFICERS. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | ASSOCIATION DUES & OTHER FEES 57,019 0 0 PURCHASED/CONTRACT SERVICES 586,319 0 0 |
| ADDITIONAL INFORMATION | FORM 990, PART X | LINE 1 - MIDMICHIGAN URGENT CARE IS PART OF A POOLED ACCOUNT THAT HAD POSITIVE CASH AT JUNE 30, 2013. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| MIDMICHIGAN HEALTH | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 382459948 | SUPPORT | MI | 501C3 | 11A | NA | false |
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 380833014 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN MEDICAL CENTER-GRATIOT | ||||||||||
| 300 E WARWICK DR | ALMA | MI | 48801 | 381437919 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN MEDICAL CENTER-CLARE | ||||||||||
| 703 NORTH MCEWAN STREET | CLARE | MI | 48617 | 381518643 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN MEDICAL CENTER-GLADWIN | ||||||||||
| 515 QUARTER STREET | GLADWIN | MI | 48624 | 386020434 | HOSPITAL | MI | 501C3 | 3 | MIDMI HLTH | true |
| MIDMICHIGAN STRATFORD VILLAGE | ||||||||||
| 2121 ROCKWELL DR | MIDLAND | MI | 48642 | 382623324 | LT CARE | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMICHIGAN GLADWIN PINES | ||||||||||
| 449 QUARTER STREET | GLADWIN | MI | 48624 | 382754875 | LT CARE | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMI VNA DBA MIDMICHIGAN HOME CARE | ||||||||||
| 3007 N SAGINAW RD | MIDLAND | MI | 48640 | 381459397 | HOME CARE | MI | 501C3 | 9 | MIDMI HLTH | true |
| MIDMICHIGAN PHYSICIANS GROUP | ||||||||||
| 2620 W SUGNET ROAD | MIDLAND | MI | 48640 | 383317788 | MED OFFICE | MI | 501C3 | 11A | MIDMI HLTH | true |
| MIDMICHIGAN REGIONAL IMAGING | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 352182295 | MED EQUIP | MI | 501C3 | 11B | MIDMI HLTH | true |
| MIDMICHIGAN HEALTH DEVELOPMENT ASSO | ||||||||||
| 4000 WELLNESS DRIVE | MIDLAND | MI | 48670 | 382459947 | OPERATIONS | MI | 501C2 | MIDMI HLTH | true | |
| REGIONAL DIALYSIS SERVICES | ||||||||||
| PO BOX 188 | ALMA | MI | 48801 | 383120704 | DIALYSIS | MI | 501C3 | 11A | MIDMI HLTH | true |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMICHIGAN ASSURANCE GROUP LTD | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1051 23 LIME TREE BAY AVE | AddressLine1 |
| Address Line2 | GOVERNORS SQUARE BLDG 4 2ND FLOOR | AddressLine2 |
| Province Or State | GRAND CAYMAN | ProvinceOrState |
| Country | CJ | Country |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 980585596 | EIN |
| Primary Activity | INSURANCE | PrimaryActivity |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountry |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDMI HLTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MIDMICHIGAN MEDICAL CENTER-MIDLAND | ||
| P | 63734 | BOOKS RECORDS |
| MIDMICHIGAN PHYSICIANS GROUP | ||
| P | 446244 | BOOKS RECORDS |