Form 990-EZ, Part I, Line 4 - Other Investment Income
“Description: INTEREST. Amount: 13.”
South Haven Health System Foundation
990EZ • Fiscal year 2016 • EIN 26-4373062
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Balance Sheet
Assets
Down$0
Down $67,698 (-100%) from 2015
Net Assets
Down$0
Down $46,959 (-100%) from 2015
Liabilities
Down$0
Down $20,739 (-100%) from 2015
Revenue And Expenses
Revenue
Down$15,062
Down $60,568 (-80%) from 2015
Expenses
Down$49,092
Down $31,142 (-39%) from 2015
Net Income
Down-$34,030
Down $29,426 (-639%) from 2015
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jul 1, 2016 to Nov 14, 2016
- Signed
- Mar 30, 2017
- Return Version
- 2016v3.0
- Gross Receipts
- $36,547
Mission and Program Overview
Mission
The purpose of the foundation is to receive and adminster funds that support mission driven pruposes by serving economically disadvantaged people through free screenings and affordable healthcare and provide resources for patients that need assistance to access professional services.
The purpose of the foundation is to receive and administer funds that support mission driven purposes by serving economically disadvantaged people through free screenings and affordable healthcare and provide resources for patients that need assistance to access professional services.
Program Services
| Description | Grants | Expenses |
|---|---|---|
| GRANT TO SOUTH HAVEN COMMUNITY HOSPITAL AUTHORITY | $34,923 | $34,923 |
| WELLNESS CENTER SCHOLARSHIPS | $12,500 | $12,500 |
Compensation and Service Providers
Employees
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| DON HIXSON | President | - | $0 | - | - |
| SUE MANNING | Board Member | - | $0 | - | - |
| JUDY GRAFF | Board Member | - | $0 | - | - |
| JULIE COWIE | Vice President | - | $0 | - | - |
| LAURA BECKWITH | Secretary/Treasurer | - | $0 | - | - |
| CRAIG RICHARDS | Board Member | - | $0 | - | - |
| Liz Jeltima | Board Member | - | $0 | - | - |
Fundraising, Events, and Gaming
Fundraising Events
| Event | Gross Receipts | Gross Revenue | Direct Expenses | Net Income |
|---|---|---|---|---|
| Blueberry 5k | $28,932 | $28,932 | $19,672 | $9,260 |
| Total Events | $28,932 | $28,932 | $21,485 | $7,447 |
Filing and Contact Details
Filer
- Filer Name
- South Haven Health System
- EIN
- 26-4373062
- Phone
- 2696392801
- Address
- 955 SOUTH BAILEY AVE, SOUTH HAVEN, MI 49090
Signing Officer
- Name
- Mark Gross
- Title
- Executive Vice President/CFO
- Phone
- 2696392801
- Signed
- 2017-03-30
- Discuss with paid preparer
- Yes
Preparer
- Firm
- Plante & Moran Pllc
- Address
- 511 Renaissance Dr Ste 120, St Joseph, MI 49085
- Preparer
- Carol Lalonde CPA
- Phone
- 2699828000
Supplemental Narrative
Additional Explanations
Form 990-EZ, Part I, Line 8 - Other Revenue
“Description: MISCELLANEOUS. Amount: 6,462.”
Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid
“Activity Classification: SCHOLARSHIPS. Grantee Name: 56 RECIPIENTS. Amount Given: 12,500.”
Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid
“Activity Classification: Transfer to Affiliate. Grantee Name: South Haven Community Hospital Authority. Amount Given: 34,923. Total included on Form 990-EZ, line 10: 47,423.”
Form 990-EZ, Part I, Line 16 - Other Expenses
“Description: OTHER. Amount: 866. Description: OTHER EVENT EXPENSE. Amount: 803. Total to Form 990-EZ, line 16: 1,669.”
Form 990-EZ, Part II, Line 24 - Other Assets
“Description: Accounts Receivable. Beg. of Year Amount: 5,200. End of Year Amount: 0.”
Form 990-EZ, Part II, Line 26 - Other Liabilities
“Description: Accrued Liabilities. Beg. of Year Amount: 5,764. End of Year Amount: 0.”
Raw XML Appendix233 raw XML fields
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| IRS990EZ/OrganizationHadUBIInd | 0 | 0 |
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| IRS990EZ/PrimaryExemptPurposeTxt | 0 | THE PURPOSE OF THE FOUNDATION IS TO RECEIVE AND ADMINISTER FUNDS THAT SUPPORT MISSION DRIVEN PURPOSES BY SERVING ECONOMICALLY DISADVANTAGED PEOPLE THROUGH FREE SCREENINGS AND AFFORDABLE HEALTHCARE AND PROVIDE RESOURCES FOR PATIENTS THAT NEED ASSISTANCE TO ACCESS PROFESSIONAL SERVICES. |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt | 0 | GRANT TO SOUTH HAVEN COMMUNITY HOSPITAL AUTHORITY |
| IRS990EZ/ProgramSrvcAccomplishmentGrp/DescriptionProgramSrvcAccomTxt | 1 | WELLNESS CENTER SCHOLARSHIPS |
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| IRS990EZ/SubjectToProxyTaxInd | 0 | 0 |
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| IRS990ScheduleA/SupportedOrgInformationGrp/OrganizationTypeCd | 0 | 3 |
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| IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt | 0 | 34923 |
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| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt | 0 | 2016-11-15 |
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| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | Description: INTEREST. Amount: 13. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | Description: MISCELLANEOUS. Amount: 6,462. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | Activity Classification: SCHOLARSHIPS. Grantee Name: 56 RECIPIENTS. Amount Given: 12,500. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | Activity Classification: Transfer to Affiliate. Grantee Name: South Haven Community Hospital Authority. Amount Given: 34,923. Total included on Form 990-EZ, line 10: 47,423. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | Description: OTHER. Amount: 866. Description: OTHER EVENT EXPENSE. Amount: 803. Total to Form 990-EZ, line 16: 1,669. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | Description: Accounts Receivable. Beg. of Year Amount: 5,200. End of Year Amount: 0. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | Description: Accrued Liabilities. Beg. of Year Amount: 5,764. End of Year Amount: 0. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Form 990-EZ, Part I, Line 4 - Other Investment Income |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Form 990-EZ, Part I, Line 8 - Other Revenue |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | Form 990-EZ, Part I, Line 16 - Other Expenses |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | Form 990-EZ, Part II, Line 24 - Other Assets |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | Form 990-EZ, Part II, Line 26 - Other Liabilities |
| TransferPrsnlBnftContractsDecl/DeclarationDesc | 0 | The organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract. |
| ReturnHeader/BuildTS | 0 | 2017-02-10 21:41:12Z |
| ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd | 0 | 1 |
| ReturnHeader/BusinessOfficerGrp/PersonNm | 0 | MARK GROSS |
| ReturnHeader/BusinessOfficerGrp/PersonTitleTxt | 0 | EXECUTIVE VICE PRESIDENT/CFO |
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| ReturnHeader/BusinessOfficerGrp/SignatureDt | 0 | 2017-03-30 |
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| ReturnHeader/Filer/BusinessNameControlTxt | 0 | SOUT |
| ReturnHeader/Filer/EIN | 0 | 264373062 |
| ReturnHeader/Filer/PhoneNum | 0 | 2696392801 |
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| ReturnHeader/Filer/USAddress/CityNm | 0 | SOUTH HAVEN |
| ReturnHeader/Filer/USAddress/StateAbbreviationCd | 0 | MI |
| ReturnHeader/Filer/USAddress/ZIPCd | 0 | 49090 |
| ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId | 0 | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 |
| ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId | 0 | D37129D5A3F72162EC81DBBB5D9BEE8558F84DD7 |
| ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd | 0 | P |
| ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt | 0 | 67.59.56.30 |
| ReturnHeader/FilingSecurityInformation/IPDt | 0 | 2017-03-30 |
| ReturnHeader/FilingSecurityInformation/IPTimezoneCd | 0 | ED |
| ReturnHeader/FilingSecurityInformation/IPTm | 0 | 12:05:52 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmEIN | 0 | 381357951 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | PLANTE & MORAN PLLC |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | 511 Renaissance Dr Ste 120 |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | St Joseph |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | MI |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 49085 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 2699828000 |
| ReturnHeader/PreparerPersonGrp/PreparationDt | 0 | 2017-03-29 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | CAROL LALONDE CPA |
| ReturnHeader/ReturnTs | 0 | 2017-03-31T08:57:36-05:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990EZ |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2016-07-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2016-11-14 |
| ReturnHeader/TaxYr | 0 | 2016 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2016 • Form 990EZDetailed filing. Detailed filing data is available for this year.
- Assets
- $0
- Liabilities
- $0
- Net assets
- $0
- Revenue
- $15,062
- Expenses
- $49,092
- Net income
- -$34,030