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MUNSON HEALTHCARE FOUNDATIONS: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MUNSON HEALTHCARE FOUNDATIONS (EIN 38-2642724)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201221359349304152
Schema version
2010v3.7
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)
Timestamp2012-05-14T13:11:15-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN382642724EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MUNSON HEALTHCARE REGIONALBusinessNameLine1
Business Name Line2FOUNDATIONBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMUNSNameControl
Phone2319355000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1188AddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code496851188ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK HEPLERName
TitleCHIEF FINANCIAL OFFICERTitle
Phone2319355000Phone
Date Signed2012-05-11DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDESIREE WORTHINGTONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1210 BEAUMONT PLAddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49684ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4642945GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MUNSONHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionINSPIRING CHARITABLE SUPPORT TO ENHANCE HEALTH CARE FOR THE PEOPLE OF NORTHERN MICHIGAN. THE PURPOSES FOR WHICH MUNSON HEALTHCARE REGIONAL FOUNDATION IS ORGANIZED ARE: A) TO PROVIDE SUPPORT FOR THE OBJECTS AND PURPOSES OF MUNSON HEALTHCARE, A MICHIGAN NONPROFIT CORPORATION AND ITS AFFILIATES, INCLUDING MUNSON MEDICAL CENTER, MUNSON HOME CARE, NORTH FLIGHT, INC., AND KALKASKA MEMORIAL HEALTH CENTER; B) TO ASSIST IN A CHARITABLE MANNER, IN THE ACCOMPLISHMENT OF THE HEALTH CARE PURPOSES OF MUNSON HEALTHCARE AND ITS AFFILIATES; C) TO OBTAIN FUNDS TO SUPPORT PUBLIC CHARITIES IN THE AREA OF HEALTH MAINTENANCE, EDUCATION AND PREVENTION OF DISEASES; D) TO PROVIDE A BENEFIT TO MUNSON HEALTHCARE AND ITS AFFILIATES BY DISTRIBUTING INCOME OR TRANSFERRING ASSETS TO OR OTHERWISE SUPPORTING THEM; E) TO PARTICIPATE TO THE FULLEST EXTENT POSSIBLE WITHIN THE RESTRICTIONS OF THE CORPORATION'S FUNDS AND ASSETS IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY; F) TO PAActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3030365ContributionsGrantsPriorYear
Contributions Grants Current Year2876379ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1044678ProgramServiceRevenuePriorYear
Program Service Revenue CY1138417ProgramServiceRevenueCY
Investment Income Prior Year288991InvestmentIncomePriorYear
Investment Income Current Year628149InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year4364034TotalRevenuePriorYear
Total Revenue Current Year4642945TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1283117GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1504601GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year800609TotalFundrsngExpCurrentYear
Other Expense Prior Year1044682OtherExpensePriorYear
Other Expenses Current Year1138425OtherExpensesCurrentYear
Total Expenses Prior Year2327799TotalExpensesPriorYear
Total Expenses Current Year2643026TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2036235RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1999919RevenuesLessExpensesCY
Total Assets BOY14387175TotalAssetsBOY
Total Assets EOY17865920TotalAssetsEOY
Total Liabilities BOY327732TotalLiabilitiesBOY
Total Liabilities EOY564354TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14059443NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17301566NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionINSPIRING CHARITABLE SUPPORT TO ENHANCE HEALTH CARE FOR THE PEOPLE OF NORTHERN MICHIGAN. THE PURPOSES FOR WHICH MUNSON HEALTHCARE REGIONAL FOUNDATION IS ORGANIZED ARE: A) TO PROVIDE SUPPORT FOR THE OBJECTS AND PURPOSES OF MUNSON HEALTHCARE, A MICHIGAN NONPROFIT CORPORATION AND ITS AFFILIATES, INCLUDING MUNSON MEDICAL CENTER, MUNSON HOME CARE, NORTH FLIGHT, INC., AND KALKASKA MEMORIAL HEALTH CENTER; B) TO ASSIST IN A CHARITABLE MANNER, IN THE ACCOMPLISHMENT OF THE HEALTH CARE PURPOSES OF MUNSON HEALTHCARE AND ITS AFFILIATES; C) TO OBTAIN FUNDS TO SUPPORT PUBLIC CHARITIES IN THE AREA OF HEALTH MAINTENANCE, EDUCATION AND PREVENTION OF DISEASES; D) TO PROVIDE A BENEFIT TO MUNSON HEALTHCARE AND ITS AFFILIATES BY DISTRIBUTING INCOME OR TRANSFERRING ASSETS TO OR OTHERWISE SUPPORTING THEM; E) TO PARTICIPATE TO THE FULLEST EXTENT POSSIBLE WITHIN THE RESTRICTIONS OF THE CORPORATION'S FUNDS AND ASSETS IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY; F) TO PAMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense885750Expense
Grants885750Grants
Revenue714907Revenue
DescriptionFUNDS FOR THE SUPPORT OF MUNSON MEDICAL CENTER, A RELATED ORGANIZATION IN THE MUNSON HEALTHCARE SYSTEM. MAJOR INITIATIVES FUNDED INCLUDE PEDIATRIC PROGRAMS,UNMET HEALTHCARE NEEDS OF PATIENTS IN THE MUNSON SERVICE AREA, MEDICAL EQUIPMENT PURCHASES, FUNDS FOR THE HEALTHY FUTURES PROGRAM, SUPPORT FOR THE NORTHERN DIABETES INITIATIVE, PATIENT TRANSPORT ASSISTANCE, WOMEN'S CANCER FUND DISTRIBUTIONS TO PATIENTS, THE EEG PROJECT, FUNDS FOR THE NORTHERN MI ADAPTIVE SPORTS PROGRAM, CONTINUING MEDICAL EDUCATION, NURSING AND STAFF TRAINING, DIABETES EDUCATION, THE MSU COLLEGE OF HUMAN MEDICINE PROGRAM, THE SIM LAB EQUIPMENT PURCHASES, SUPPORT OF MUNSON MANOR AND OTHER HOSPITAL BASED PROGRAMS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense524718Expense
Grants524718Grants
Revenue423510Revenue
DescriptionFUNDS TO SUPPORT MUNSON HOME CARE'S HOSPICE & PALLIATIVE CARE PROGRAM WHICH PROVIDES COMPASSIONATE, END-OF-LIFE CARE TO PATIENTS AND FAMILIES IN NORTHWEST MICHIGAN (INCLUDING ANTRIM, BENZIE, GRAND TRAVERSE, KALKASKA, LEELANAU, MANISTEE, MASON, OTSEGO AND WEXFORD COUNTIES). THE HEART OF THE PROGRAM'S MISSION IS TO SERVE INDIVIDUALS AND THEIR FAMILIES DURING THEIR GREATEST TIME OF NEED. SINCE 1978, MUNSON HOME CARE HAS CARED FOR OVER 10,000 PATIENTS LIVING WITH ADVANCED ILLNESS OR CONDITION, THEIR CAREGIVERS, AND THOSE WHO HAVE LOST A LOVED ONE-REGARDLESS OF AGE, RACE, RELIGION OR FINANCIAL CIRCUMSTANCES. MUNSON HOSPICE'S PROFESSIONAL STAFF AND DEDICATED VOLUNTEERS OFFER COMFORT, PEACE, AND COMPASSION IN THE HOME OR AT THE HOSPICE HOUSE, WHICH IS LOCATED ON THE CAMPUS OF MUNSON MEDICAL CENTER. ADDITIONALLY, MUNSON HOSPICE PROVIDES GRIEF SUPPORT SERVICES TO FAMILIES FOR UP TO ONE YEAR AFTER THE LOSS OF A LOVED ONE. HOSPICE BEREAVEMENT COUNSELORS ARE FREQUENTLY REQUESTED BY AREA SCHOOLS TO HELP STUDENTS AND TEACHERS COPE WITH THE TRAUMATIC DEATH OF A CLASSMATE OR OTHER CRISIS. OUR INNOVATIVE PALLIATIVE CARE PROGRAM GUIDES PATIENTS AND FAMILIES THROUGH DIFFICULT CONVERSATIONS AND CHOICES ABOUT TREATMENT AND PAIN MANAGEMENT.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense27681Expense
Grants27681Grants
DescriptionFUNDS WERE DISTRIBUTED FOR NURSING SCHOLARSHIPS.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense66452Expense
Grants66452Grants
DescriptionMUNSON HEALTHCARE REGIONAL FOUNDATION GRANTS FUNDS TO PROVIDE FOR UNMET HEALTHCARE NEEDS IN THE MUNSON HEALTHCARE SERVICE AREA. MUCH OF THIS IS DIRECT SUPPORT TO PATIENTS WHO REQUIRE ASSISTANCE ACCESSING HEALTHCARE AND PAYING FOR SUPPORTIVE HEALTHCARE NEEDS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp66452TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt66452TotalOfOtherProgramServiceGrnt
Total Program Service Expense1504601TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusetrueMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MUNSON HEALTHCARE CORPORATE FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2319357777TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13668 N US 31 SAddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49684ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
EDWIN NESS
DIRECTOR4.00X0637756139446
DESIREE WORTHINGTON
PRESIDENT34.00X019129537718X
LORRAINE BEERS
DIRECTOR2.00X06991916986
GEORGE BEARUP
DIRECTOR2.00X0125000
ALICE SHIRLEY
DIRECTOR2.00X000
ANN WARD GREGORY
DIRECTOR2.00X000
BRUCE REAVELY
DIRECTOR2.00X000
CATHERINE L MARTIN
DIRECTOR2.00X000
CHARLES BUMB
DIRECTOR2.00X000X
CHARLES HAVILL
DIRECTOR2.00X000
CYNTHIA GLINES MD
DIRECTOR2.00X000
DENNIS PEARSALL
DIRECTOR2.00X000
EDWARD RUTKOWSKI MD
DIRECTOR2.00X000
JON S ARMSTRONG
TREASURER2.00X000X
KYLE CARR MD
SECRETARY2.00X000X
PAUL SCHMUCKAL
DIRECTOR2.00X000
PHILLIP GOETHALS
DIRECTOR2.00X000
REV HOMER NYE
DIRECTOR2.00X000X
RONALD YOCUM
DIRECTOR2.00X000
ROSS BIEDERMAN
DIRECTOR2.00X000
SARAH WATKINS TRIPPE
DIRECTOR2.00X000
KATHY DIXON
DIRECTOR2.00X000
MARK A HEPLER
CFO1.00024909945753X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1160569TotalReportableCompFrmRltdOrgs
Total Other Compensation239903TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
All Other Contributions2876379AllOtherContributions
Noncash Contributions12850NoncashContributions
Total Contributions2876379TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionSHARED SERVICE REVENUEDescription
Business Code541900BusinessCode
Total Revenue Column1138417TotalRevenueColumn
Related Or Exempt Function Income1138417RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1138417TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column205209TotalRevenueColumn
Exclusion$205,209ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities422940Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities422940Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column422940TotalRevenueColumn
Exclusion$422,940ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4642945TotalRevenueColumn
Related Or Exempt Function Income1138417RelatedOrExemptFunctionIncome
Exclusion$628,149ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1432243Total
Program Services1432243ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total72358Total
Program Services72358ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total22331Total
Management And General22331ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3600Total
Management And General3600ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total945930Total
Management And General254554ManagementAndGeneral
Fundraising691376Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total522Total
Fundraising522Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total77683Total
Management And General18803ManagementAndGeneral
Fundraising58880Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total12696Total
Management And General12696ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total18096Total
Management And General12493ManagementAndGeneral
Fundraising5603Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total336Total
Management And General336ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3265Total
Management And General3265ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalFundraisingFundraisingManagement And GeneralManagementAndGeneral
DONOR RECOGNITION2706627066
MISCELLANEOUS21188171624026
DUES AND SUBSCRIPTIONS40594059
REPAIRS16531653

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2643026Total
Program Services1504601ProgramServices
Management And General337816ManagementAndGeneral
Fundraising800609Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY131247BOY
EOY215150EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1124902BOY
EOY1213464EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY790BOY
EOY5799EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY20200EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis19635LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11301LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1726BOY
EOY8334EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY13118596BOY
EOY15412634EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9914BOY
EOY990339EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY14387175BOY
EOY17865920EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY18983BOY
EOY24715EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY308749BOY
EOY539639EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY327732BOY
EOY564354EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11102BOY
EOY11102EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12355895BOY
EOY15598018EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1692446BOY
EOY1692446EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14059443BOY
EOY17301566EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14387175BOY
EOY17865920EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1999919ReconcilationRevenueExpenses
Reconcilation Other Changes1242204ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2175616CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4104161CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years911071CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3030365CurrentTaxYearMinus1Year
Current Tax Year2876379CurrentTaxYear
Total13097592Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2175616CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4104161CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years911071CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3030365CurrentTaxYearMinus1Year
Current Tax Year2876379CurrentTaxYear
Total13097592Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total1986038AmountsSubstContributorsTotal
Public Support Total17011111554PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years280426CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years408864CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years230852CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year117795CurrentTaxYearMinus1Year
Current Tax Year205209CurrentTaxYear
Total1243146Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years600CurrentTaxYearMinus2Years
Total600Total
FieldValueIRS element (for citing)
Total Support14341338TotalSupport
Gross Receipts From Admissions Etc1138417GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.77480PublicSupportPertcentage170
Public Support Pertcent Prior Year0.73720PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSHARED SERVICE REVENUE IS A REIMBURSEMENT OF THE FOUNDATION'S EXPENSES BY MUNSON HEALTHCARE, MUNSON MEDICAL CENTER, AND SEVERAL OTHER ORGANIZATIONS THAT BENEFIT FROM THE FOUNDATION'S FUNDRAISING EFFORTS. THE REIMBURSEMENT IS NOT CONSIDERED SUPPORT OF THE FOUNDATION, BUT MERELY A REIMBURSEMENT OF EXPENSES TO COVER THE COST OF THE FOUNDATION'S OPERATIONS. THEREFORE, THE REIMBURSEMENT AMOUNTS ARE NOT INCLUDED IN THE SUPPORT SCHEDULE, IN ACCORDANCE WITH THE INSTRUCTION DEFINITIONS.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance13118596BeginningOfYearBalance
Contributions1937725Contributions
Investment Earnings Or Losses1913713InvestmentEarningsOrLosses
Grants Or Scholarships1443489GrantsOrScholarships
Other Expenditures70515OtherExpenditures
Administrative Expenses43396AdministrativeExpenses
End Of Year Balance15412634EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance11231905BeginningOfYearBalance
Contributions2470828Contributions
Investment Earnings Or Losses873307InvestmentEarningsOrLosses
Grants Or Scholarships1384703GrantsOrScholarships
Other Expenditures48493OtherExpenditures
Administrative Expenses24248AdministrativeExpenses
End Of Year Balance13118596EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance14478163BeginningOfYearBalance
Contributions1592179Contributions
Investment Earnings Or Losses-1327950InvestmentEarningsOrLosses
Grants Or Scholarships1029785GrantsOrScholarships
Other Expenditures2455542OtherExpenditures
Administrative Expenses25160AdministrativeExpenses
End Of Year Balance11231905EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.10980PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.89020TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis19635OtherCostOrOtherBasis
Depreciation11301Depreciation
Book Value8334BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8334TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionOTHER ACCOUNTS RECEIVABLEDescription
Book Value990339BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets990339TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
LIABILITY FOR CHARITABLE GIFT ANNUIT$327,870
AFFILIATE ACCOUNTS PAYABLE$211,769
FieldValueIRS element (for citing)
Total Of Amounts539639TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USES FOR ENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4ReturnReference
ExplanationMUNSON HEALTHCARE REGIONAL FOUNDATION HOLDS PERMANENT ENDOWMENT FUNDS FOR MUNSON MEDICAL CENTER, BROTHER CORPORATION; FOR NURSING SCHOLARSHIPS; AND FOR OTHER ENTITIES IN THE MUNSON HEATLHCARE SYSTEM. QUASI-ENDOWMENT FUNDS ARE HELD FOR A VARIETY OF HEALTHCARE NEEDS IN THE MUNSON HEALTHCARE SYSTEM. THESE INCLUDE CAPITAL REPLACEMENT AND EXPANSION; SUSTAINING FUNDS FOR SPECIFIC PROGRAMS INCLUDING THE MUNSON HOSPICE HOUSE, THE MUNSON HOSPITALITY HOUSE, PEDIATRIC PROGRAMS, WOMEN'S HEALTH ISSUES, DIABETES INITIATIVES, COMMUNITY HEALTH NEEDS, RESEARCH, PATIENT TRANSPORT, PROFESSIONAL AND PATIENT EDUCATION, AND MANY OTHER IDENTIFIED INTERESTS OF MUNSON HEALTHCARE AND THE COMMUNITIES IT SERVES; AND FUNDS FOR PATIENTS WHO REQUIRE FINANCIAL ASSISTANCE TO OBTAIN HEALTH CARE OR FURTHER THEIR ABILITY TO RECEIVE HEALTH CARE.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantBusiness Name Line2RecipientNameBusiness/BusinessNameLine2
MUNSON MEDICAL CENTER
1105 SIXTH STTRAVERSE CITYMI49684381362830(3)885750SUPPORT HOSPITAL
MUNSON HOME CARE
1105 SIXTH STTRAVERSE CITYMI49684382191390(3)524718HOSPICE & PALLIATIVE
GRAND TRAVERSE COUNTY HEALTH
2325 GARFIELD RD NORTH SUITE BTRAVERSE CITYMI49686386004852GOV6000WOMEN & YOUTH HEALTHDEPARTMENT
TRAVERSE HEALTH CLINIC
3155 LOGAN VALLEY ROADTRAVERSE CITYMI49684300224028(3)10000WOMEN'S HEALTH NEEDS
GRAND TRAVERSE RADIOLOGISTS
10850 TRAVERSE HIGHWAYTRAVERSE CITYMI496843818762995775MAMMOGRAMS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
SCHOLARSHIPS1627681
PATIENT NEEDS FUNDS65144677

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATESIdentifier
Return ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2ReturnReference
ExplanationTHE MUNSON HEALTHCARE REGIONAL FOUNDATION REQUESTS AND RECEIVES REPORTS FROM PROGRAM MANAGERS FOR PROJECTS SUPPORTED WITHIN THE MUNSON HEALTHCARE SYSTEM. SCHOLARSHIPS ARE AVAILABLE FOR BOOKS, TUITION AND LAB FEES FOR THOSE GOING INTO NURSING OR PRIORITY HEALTH CARE FIELDS. RECIPIENTS ARE REIMBURSED FOR ITEMS COVERED UNDER THE TERMS OF THE SCHOLARSHIP. GRANTEES MUST TURN IN RECEIPTS AND GRADE REPORTS TO SUBSTANTIATE ELIGIBILITY, WHICH ARE THEN PROCESSED AND PAID OUT OF SCHOLARSHIP MONIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
EDWIN NESS
515678120976110211932020126777202
DESIREE WORTHINGTON
158243328951571791819800229013
MARK A HEPLER
2088753879514292637519378294852

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSSCHEDULE J, PAGE 1, PART I, LINE 4EDWIN NESS 0 107,176 0 DESIREE WORTHINGTON 0 9,870 0 MARK A. HEPLER 0 13,842 0
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIISUBJECT TO REVIEW AND APPROVAL BY THE BOARD COMPENSATION AND EXECUTIVE LEADERSHIP COMMITTEE, IN ORDER TO RECRUIT AND MAINTAIN QUALIFIED EXECUTIVES, INCLUDING THE PRESIDENT AND VICE-PRESIDENTS OF MUNSON HEALTHCARE, A COMPETITIVE BENEFIT PACKAGE IS OFFERED WHICH INCLUDES PARTICIPATION IN A SUPPLEMENTAL RETIREMENT PLAN. ANNUAL CONTRIBUTIONS, AT MUNSON'S DISCRETION, ARE MADE TO THE PLAN IN ORDER TO ACHIEVE THE TARGETED RETIREMENT BENEFIT LEVEL. THESE RETIREMENT FUNDS ARE AVAILABLE TO THE PARTICIPANTS UPON THEIR RETIREMENT FROM MUNSON.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONINSPIRING CHARITABLE SUPPORT TO ENHANCE HEALTH CARE FOR THE PEOPLE OF NORTHERN MICHIGAN. THE PURPOSES FOR WHICH MUNSON HEALTHCARE REGIONAL FOUNDATION IS ORGANIZED ARE: A) TO PROVIDE SUPPORT FOR THE OBJECTS AND PURPOSES OF MUNSON HEALTHCARE, A MICHIGAN NONPROFIT CORPORATION AND ITS AFFILIATES, INCLUDING MUNSON MEDICAL CENTER, MUNSON HOME CARE, NORTH FLIGHT, INC., AND KALKASKA MEMORIAL HEALTH CENTER; B) TO ASSIST IN A CHARITABLE MANNER, IN THE ACCOMPLISHMENT OF THE HEALTH CARE PURPOSES OF MUNSON HEALTHCARE AND ITS AFFILIATES; C) TO OBTAIN FUNDS TO SUPPORT PUBLIC CHARITIES IN THE AREA OF HEALTH MAINTENANCE, EDUCATION AND PREVENTION OF DISEASES; D) TO PROVIDE A BENEFIT TO MUNSON HEALTHCARE AND ITS AFFILIATES BY DISTRIBUTING INCOME OR TRANSFERRING ASSETS TO OR OTHERWISE SUPPORTING THEM; E) TO PARTICIPATE TO THE FULLEST EXTENT POSSIBLE WITHIN THE RESTRICTIONS OF THE CORPORATION'S FUNDS AND ASSETS IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY; F) TO PARTICIPATE IN ESTABLISHING AND ACHIEVING MUNSON HEALTHCARE'S REGIONAL FUNDRAISING TARGETS AND GOALS IN ACCORDANCE WITH MUNSON HEALTHCARE'S FUNDRAISING PLANS AND STRATEGIES; AND G) TO SUPPORT AND PARTICIPATE IN THE ACHIEVEMENT OF THE MISSION OF MUNSON HEALTHCARE AND ITS AFFILIATES, CONSISTENT WITH THEIR COLLECTIVE MISSION.
SECOND ACHIEVEMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4BCENTER. ADDITIONALLY, MUNSON HOSPICE PROVIDES GRIEF SUPPORT SERVICES TO FAMILIES FOR UP TO ONE YEAR AFTER THE LOSS OF A LOVED ONE. HOSPICE BEREAVEMENT COUNSELORS ARE FREQUENTLY REQUESTED BY AREA SCHOOLS TO HELP STUDENTS AND TEACHERS COPE WITH THE TRAUMATIC DEATH OF A CLASSMATE OR OTHER CRISIS. OUR INNOVATIVE PALLIATIVE CARE PROGRAM GUIDES PATIENTS AND FAMILIES THROUGH DIFFICULT CONVERSATIONS AND CHOICES ABOUT TREATMENT AND PAIN MANAGEMENT.
ALL OTHER ACHIEVEMENTS DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DMUNSON HEALTHCARE REGIONAL FOUNDATION GRANTS FUNDS TO PROVIDE FOR UNMET HEALTHCARE NEEDS IN THE MUNSON HEALTHCARE SERVICE AREA. MUCH OF THIS IS DIRECT SUPPORT TO PATIENTS WHO REQUIRE ASSISTANCE ACCESSING HEALTHCARE AND PAYING FOR SUPPORTIVE HEALTHCARE NEEDS.
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2MARK A. HEPLER DESIREE WORTHINGTON CFO PRES MFD MUNSON HEALTHCARE EMPLOYER
MATERIAL DIVERSION OF ASSETSFORM 990, PAGE 6, PART VI, LINE 5IN APRIL 2011, THE MUNSON HEALTHCARE REGIONAL FOUNDATION (ORGANIZATION) BECAME AWARE OF A POSSIBLE DIVERSION OF CASH BY AN EMPLOYED ACCOUNTANT RESPONSIBLE FOR PREPARING THE ORGANIZATION'S FINANCIAL STATEMENTS. AN INTERNAL INVESTIGATION WAS IMMEDIATELY LAUNCHED, AND AS OF JULY 19, 2011, THE DIVERSION WAS CONFIRMED AND THE AMOUNT QUANTIFIED AT 1,105,000.00. THE ORGANIZATION TOOK CORRECTIVE ACTIONS TO ADDRESS THE MATTER INCLUDING: 1)TERMINATING THE EMPLOYEE'S EMPLOYMENT 2)REPORTING THE EMPLOYEE'S THEFT TO LAW ENFORCEMENT AND COOPERATING IN THE SUBSEQUENT CRIMINAL PROSECUTION (THE EMPLOYEE WAS CONVICTED OF TWO CRIMES AND SENTENCED TO 46 MONTHS IN PRISON) 3)REPORTING THE LOSS TO THE ORGANIZATION'S INSURANCE COMPANY, WHICH RESULTED IN RECOVERY OF THE ENTIRE AMOUNT OF THE THEFT LESS THE 25,000 DEDUCTIBLE 4)RETAINING AN INDEPENDENT FRAUD INVESTIGATOR TO DETERMINE THE METHOD OF THE THEFT. 5)REVISING INTERNAL CONTROLS AND SEGREGATING ACCOUNTING DUTIES TO ENSURE THIS TYPE OF THEFT DOES NOT OCCUR AGAIN.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6MUNSON HEALTHCARE REGIONAL FOUNDATION IS ORGANIZED ON A NONSTOCK MEMBERSHIP BASIS. THE SOLE MEMBER IS MUNSON HEALTHCARE, AN IRS SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ATRUSTEES ARE ELECTED FROM AMONG THOSE PERSONS NOMINATED BY THE MUNSON HEALTHCARE GOVERNANCE COMMITTEE. ADDITIONALLY, THE PRESIDENT OF MUNSON HEALTHCARE OR DESIGNEE AND THE PRESIDENT OF MUNSON HEALTHCARE REGIONAL FOUNDATION SERVE AS TRUSTEES ON AN EX-OFFICIO BASIS, WITH VOTE.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BCERTAIN DECISIONS OF THE MUNSON HEALTHCARE REGIONAL FOUNDATION TRUSTEES ARE SUBJECT TO APPROVAL BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS INCLUDING THE AMENDMENT OF THE ARTICLES OF INCORPORATION; AMENDMENT OF THE MISSION STATEMENT; ADOPTION OF A PLAN OF DISSOLUTION, MERGER, CONSOLIDATION OR REORGANIZATION; SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL TO THE PROPERTY AND ASSETS; ACCEPTANCE OF THE ANNUAL BUDGET AND ANNUAL FINANCIAL STATEMENTS; INCURRENCE OF EXPENDITURES EXCEEDING BUDGETED AGGREGATES BY MORE THAN FIVE PERCENT; INCURRENCE OF CERTAIN DEBT; AND APPOINTMENT OF THE PRESIDENT.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE MUNSON HEALTHCARE REGIONAL FOUNDATION BOARD IS COMMITTED TO THE ACCURACY AND THOROUGHNESS OF THE FORM 990 REPORTING. MUNSON HEALTHCARE REGIONAL FOUNDATION BELONGS TO THE MUNSON HEALTHCARE SYSTEM. MUNSON HEALTHCARE IS THE PARENT COMPANY IN THE MUNSON HEALTHCARE SYSTEM, WHICH UNDERGOES AN AUDIT BY AN EXTERNAL AUDIT FIRM. AT THE CORPORATE LEVEL, THE RESPONSIBLE INDIVIDUALS FROM THE FINANCE, ADMINISTRATION, BUSINESS, LEGAL, HUMAN RESOURCES, PUBLIC RELATIONS, AND FUND DEVELOPMENT DEPARTMENTS PREPARE AND REVIEW PORTIONS OF THE FORM 990. BOARD COMMITTEES THEN FURTHER REVIEW SPECIFIC DISCLOSURES. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION INFORMATION CONTAINED IN THE CORE FORM AS WELL AS THE SCHEDULE J INFORMATION. THE CONFLICT, VALUATION AND COMPLIANCE COMMITTEE OVERSEES THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR BOARD MEMBERS AND KEY EMPLOYEES TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE AUDIT COMMITTEE REVIEWS MUNSON HEALTHCARE, MUNSON MEDICAL CENTER, MUNSON HEALTHCARE REGIONAL FOUNDATION, AND SELECTED OTHER SYSTEM ENTITY FORMS 990 ON AN ANNUAL BASIS.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE MUNSON HEALTHCARE, SOLE MEMBER, BOARD HAS A STANDING CONFLICT, VALUATION, AND COMPLIANCE ("CVC") COMMITTEE. ANY TRANSACTIONS WITH DISQUALIFIED PERSONS ARE SUBJECT TO PRIOR APPROVAL OF FAIR MARKET VALUE BY THE CVC COMMITTEE. ANNUALLY, THE CVC COMMITTEE DIRECTS THE PROCESS FOR EACH DIRECTOR AND KEY EMPLOYEE OF MUNSON HEALTHCARE REGIONAL FOUNDATION TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THE RESPONSES ARE REVIEWED AND SUMMARIZED BY MUNSON HEALTHCARE'S LEGAL DEPARTMENT. A REPORT OF IDENTIFIED CONFLICTS IS PRESENTED TO THE CVC COMMITTEE FOR ITS REVIEW AND APPROVAL. THE CVC COMMITTEE UTILIZES THE QUESTIONNAIRE RESPONSES TO EVALUATE ANY TRANSACTION WITH A POTENTIAL CONFLICT.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE PROCESS FOR DETERMINING APPROPRIATE LEVELS OF PAY FOR EXECUTIVE POSITIONS WITHIN MUNSON HEALTHCARE SYSTEM IS CAREFULLY AND THOUGHTFULLY DIRECTED BY THE MUNSON HEALTHCARE BOARD OF DIRECTORS, THROUGH THE COMPENSATION AND EXECUTIVE LEADERSHIP DEVELOPMENT COMMITTEE. THE COMMITTEE UTILIZES "BEST PRACTICES" METHODS OF DETERMINING COMPENSATION AND, AS SUCH, IS COMPOSED OF SEVEN MEMBERS WHOSE VOTING MEMBERS ARE INDEPENDENT. THE COMMITTEE IS CHARGED WITH ENSURING THAT EXECUTIVE COMPENSATION IS DESIGNED TO ATTRACT AND RETAIN HIGH QUALITY, PROFESSIONAL LEADERSHIP WHILE MAINTAINING STRONG STEWARDSHIP FOR THE ORGANIZATION. ANNUALLY, THE COMMITTEE RETAINS A NATIONAL INDEPENDENT CONSULTANT TO ENSURE THAT MUNSON HEALTHCARE'S COMPENSATION PRACTICES AND LEVELS ARE INDEPENDENTLY REVIEWED WHILE BEING COMPETITIVE AND REASONABLE. COMPENSATION LEVELS REFLECT THE SCOPE OF EACH EXECUTIVE'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE, AND INDUSTRY STANDING AS WELL AS INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. ANNUAL COMPENSATION FOR MUNSON HEALTHCARE SYSTEM EXECUTIVES IS DETERMINED, IN PART, BY MEASURABLE PROGRESS TOWARD THE ORGANIZATION'S GOALS INCLUDING CONTINUED IMPROVEMENT IN CLINICAL QUALITY, COMMUNITY HEALTH, AND OPERATIONAL EFFICIENCIES. MUNSON HEALTHCARE'S INTENT FOR EXECUTIVE BASE COMPENSATION IS TO BE AT THE MEDIAN WHEN COMPARED TO LIKE-SIZE NON-PROFIT HOSPITALS AND HEALTHCARE SYSTEMS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BCOMPENSATION OF OTHER OFFICERS IS CONSISTENT WITH THAT OF THE TOP EXECUTIVES FOR MUNSON HEALTHCARE REGIONAL FOUNDATION AND MUNSON HEALTHCARE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE MUNSON HEALTHCARE REGIONAL FOUNDATION ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON THE MICHIGAN DEPARTMENT OF TREASURY WEBSITE. MUNSON HEALTHCARE REGIONAL FOUNDATION DOES NOT MAKE THE BYLAWS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANNUALLY, MUNSON HEALTHCARE REGIONAL FOUNDATION PREPARES AND DISTRIBUTES AN ANNUAL REPORT TO THE COMMUNITY, WHICH CONTAINS FINANCIAL AS WELL AS PROGRAM DATA.
GROUP RETURN METHODFORM 990, PAGE 7, PART VIIPARENT ORGANIZATION HAS FILED A SEPARATE RETURN
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIEDWIN A. NESS WAS PRESIDENT OF MUNSON HEALTHCARE AND ALLOCATED 95% OF HIS TIME TO MUNSON HEALTHCARE SYSTEM MATTERS AND 5% OF HIS TIME TO THE MUNSON HEALTHCARE REGIONAL FOUNDATION. MARK HEPLER, CFO, ALLOCATES 30% OF HIS TIME TO MUNSON HEALTHCARE, SYSTEM PARENT ORGANIZATION; 70% TO MUNSON MEDICAL CENTER; AND LESS THAN AN HOUR A WEEK TO THE REMAINING ORGANIZATIONS IN THE MUNSON HEALTHCARE SYSTEM IN HIS CAPACITY AS CFO FOR ALL MUNSON SYSTEM ORGANIZATIONS. DESIREE WORTHINGTON ALLOCATES 85% OF HER TIME TO MUNSON HEALTHCARE REGIONAL FOUNDATION AS ITS PRESIDENT AND 15% OF HER TIME TO PAUL OLIVER MEMORIAL HOSPITAL FOUNDATION AS ITS PRESIDENT.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5THE OTHER CHANGES IN NET ASSETS INCLUDE THE FOLLOWING ITEM: UNREALIZED GAINS ON POOLED INVESTMENT ACCOUNTS 1,242,203

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Business Name Line2DirectControllingEntityName/BusinessNameLine2Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
MUNSON DIALYSIS CENTER
1105 SIXTH STTRAVERSE CITYMI49684383097861DIALYSISMI(C)(3)3MUNSON HCMUNSON HEALTHCAREfalse
MUNSON HEALTHCARE
1105 SIXTH STTRAVERSE CITYMI49684382640544PARENTMI(C)(3)11BfalseN/A
MUNSON HOME CARE
1105 SIXTH STTRAVERSE CITYMI49684382191390HOME HEALTMI(C)(3)9MUN HOME HMUNSON HOME HEALTHfalse
MUNSON HOME HEALTH
1105 SIXTH STTRAVERSE CITYMI49684383335362HOME HEALTMI(C)(3)11BMUNSON HCMUNSON HEALTHCAREfalse
MUNSON HOME SERVICES
1105 SIXTH STTRAVERSE CITYMI49684382543463HOME HEALTMI(C)(3)9MUN HOME HMUNSON HOME HEALTHfalse
MUNSON MEDICAL CENTER
1105 SIXTH STTRAVERSE CITYMI49684381362830HOSPITALMI(C)(3)3MUNSON HCMUNSON HEALTHCAREfalse
MUNSON MOBILE IMAGING INC
1105 SIXTH STTRAVERSE CITYMI49684382704069HEALTHCAREMI(C)(4)MUNSON HCMUNSON HEALTHCAREfalse
NORTH FLIGHT INC
1105 SIXTH STTRAVERSE CITYMI49684382657917MED TRANSPMI(C)(3)11BMUNSON HCMUNSON HEALTHCAREfalse
PAUL OLIVER MEMORIAL HOSPITAL
1105 SIXTH STTRAVERSE CITYMI49684381415623HEALTHCAREMI(C)(3)3MUNSON HCMUNSON HEALTHCAREfalse
PAUL OLIVER MEMORIAL HOSPITAL FOUND
1105 SIXTH STTRAVERSE CITYMI49684237201619RAISE FUNDMI(C)(3)7PAUL OLV HPAUL OLIVER MEMORIAL HOSPITALfalse
MUNSON MEDICAL GROUP
1105 SIXTH STTRAVERSE CITYMI49684273600575PHYSICIANMI(C)(3)9MUNSON MEDMUNSON MEDICAL CENTERfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNADisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
MUNSON MEDICAL BUILDING PARTNERS
PO BOX 1188TRAVERSE CITYMI496851188382830005REAL ESTATMIN/Afalsefalse
NORTHERN MICHIGAN SUPPLY ALLIANCE
2651 AERO PARK DRTRAVERSE CITYMI49686383453378PURCHASINGMIN/Afalsefalse
MUNSON MEDICAL BUILDING PARTNERS
PO BOX 1188TRAVERSE CITYMI496851188382830005REAL ESTATMIN/Afalsefalse
NORTHERN MICHIGAN SUPPLY ALLIANCE
2651 AERO PARK DRTRAVERSE CITYMI49686383453378PURCHASINGMIN/Afalsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNABusiness Name Line2NameOfRelatedOrg/BusinessNameLine2
MUNSON SUPPORT SERVICES
PO BOX 1188TRAVERSE CITYMI496851188382872821LAUNDRYMIN/A
MUNSON SERVICES INC
PO BOX 1188TRAVERSE CITYMI496851188383144382PHARMACYMIN/A
MEDICAL OFFICE BUILDING CONDOMINIUM
PO BOX 1188TRAVERSE CITYMI496851188383567278REAL ESTATMIN/AMEDICAL OFFICE BUILDING CONDOMINIUM
SIXTH STREET DRUGS INC
PO BOX 1188TRAVERSE CITYMI496851188382298290PHARMACYMIN/A
MEDICAL OFFICE CONDOMINIUM
PO BOX 1188TRAVERSE CITYMI496851188201902620REAL ESTATMIN/AMEDICAL OFFICE CONDOMINIUM
MUNSON SUPPORT SERVICES
PO BOX 1188TRAVERSE CITYMI496851188382872821LAUNDRYMIN/A
MUNSON SERVICES INC
PO BOX 1188TRAVERSE CITYMI496851188383144382PHARMACYMIN/A
MEDICAL OFFICE BUILDING CONDOMINIUM
PO BOX 1188TRAVERSE CITYMI496851188383567278REAL ESTATMIN/AMEDICAL OFFICE BUILDING CONDOMINIUM
SIXTH STREET DRUGS INC
PO BOX 1188TRAVERSE CITYMI496851188382298290PHARMACYMIN/A
MEDICAL OFFICE CONDOMINIUM
PO BOX 1188TRAVERSE CITYMI496851188201902620REAL ESTATMIN/AMEDICAL OFFICE CONDOMINIUM
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MUNSON HOME CARE
B524718FMV
MUNSON MEDICAL CENTER
B885750FMV
MUNSON HEALTHCARE
K547523FMV
MUNSON MEDICAL CENTER
K541361FMV
MUNSON HEALTHCARE
L50796FMV
MUNSON HEALTHCARE
N868659FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE RReturnReference
ExplanationMUNSON HEALTHCARE REGIONAL FOUNDATION USED THE ACCRUAL METHOD OF ACCOUNTING TO VALUE THE TRANSACTIONS WITH RELATED ENTITIES ALL INTERCOMPANY TRANSACTIONS WITH RELATED ENTITIES WERE REVIEWED SUMMARIZED AND RECONCILED TO DETERMINE THE DISCLOSURE AMOUNTSExplanation