Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 0 | 0 | 0 | 0 | 0 | 0 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | 0 | 0 | 0 | 0 | 0 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | 0 | 0 | 0 | 0 | 0 |
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 6 | Total. Add lines 1 through 5. | 0 | 0 | 0 | 0 | 0 | 0 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 0 |
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support. (Subtract line 7c from line 6.) | 0 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 0 | 0 | 0 | 0 | 0 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | 0 | 0 | 0 | 0 | 0 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 10a and 10b. | 0 | 0 | 0 | 0 | 0 | 0 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | 0 | 0 | 0 | 0 | 0 |
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | 0 | 0 | 0 | 0 | 0 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 0 | 0 | 0 | 0 | 0 | 0 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 15 Compensation | THE ORGANIZATION DID NOT COMPENSATE A TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, OR KEY EMPLOYEES FOR THEIR SERVICES TO THE ORGANIZATION. |
| Form 990, Part VI, Line 13 Whistle Blower Policy | THIS POLICY WAS DRAFTED AND UNDER REVIEW BY THE BOARD OF DIRECTORS FOR 6/30/16 . THIS POLICY WAS ADOPTED IN EARLY FISCAL YEAR 2017. |
| Form 990, Part VI, Line 14 RETENTION & DESTRUCTION POLICY | THIS POLICY WAS DRAFTED AND UNDER REVIEW BY THE BOARD OF DIRECTORS FOR 6/30/16 . THIS POLICY WAS ADOPTED IN EARLY FISCAL YEAR 2017. |
| Form 990, Part VI, Line 3 Delegation of management duties | The organization has a management services agreement with Spectrum Health Hospitals, a member organization. Spectrum Health will provide personnel and services to lead, manage, and operate North Flight Aero Med's Air Ambulance program and related operations as directed by North Flight Aero Med's Board of Directors. Services provided will include direct management of North Flight Aero Med's business, financial matters, personnel, and the provision of clinical services and communication center services. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The organization has two members as follows: - North Flight, Inc. (EIN 38-2657917) (50%), a Michigan nonprofit corporation; - Spectrum Health Hospitals (EIN 38-1360529) (50%), a Michigan nonprofit corporation. Both members are tax-exempt under Internal Revenue Code 501(C)(3). |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The members (See Form 990, Part VI, Line 6) of the organization appoint all members of the board of directors, with each member entitled to appoint three directors. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Unless otherwise noted below, the members (see Form 990, Part VI, Line 6) of the organization have the reserved powers set forth below, and shall not be deemed authorized unless and until approved by the members: - THE DISSOLUTION OF THE CORPORATION; - MERGER OR CONSOLIDATION OF THE CORPORATION; - AN AMENDMENT TO THE ARTICLES OR THESE BYLAWS; - CONVERSION OF THE CORPORATION; - THE SALE, EXCHANGE, LEASE, OR OTHER TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; - APPOINTMENT AND ELECTION OF DIRECTORS; - CHANGE IN NUMBER OF DIRECTORS; - REMOVAL OF ANY DIRECTOR; - ESTABLISHING FROM TIME TO TIME LEVELS OF APPROVAL AUTHORITY FOR THE DIRECTORS OF THE CORPORATION AND APPROVE ANY TRANSACTIONS AND EXPENDITURES EXCEEDING THE ESTABLISHED AUTHORITY FOR THE DIRECTORS; - APPROVAL OF THE MISSION AND VISION STATEMENTS FOR THE CORPORATION AND ENSURING COMPLIANCE WITH THE CORPORATION'S PHILOSOPHY, MISSION, AND VISION; - APPROVAL OF THE STRATEGIC PLAN AND CAPITAL AND OPERATING BUDGETS OF THE CORPORATION; - APPROVAL OF ANNUAL OPERATING AND CAPITAL BUDGETS RECOMMENDED BY THE DIRECTORS; AND - APPROVAL OF ANY MANDATORY CONTRIBUTION OF CAPITAL RECOMMENDED BY THE DIRECTORS. |
| Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body | THE ORGANIZATION HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A copy of the Form 990 is provided to the Board of Directors prior to filing. The review process for this Form 990 is as follows: 1. Preparation of the return is supervised and reviewed by a member organization's Corporate Tax Department. 2. A second review is performed by an external CPA firm with expertise in tax-exempt return preparation. 3. The return is reviewed by the organization's Treasurer and shared with the members of the Board of Directors. 4. The organization's treasurer reviews comments or questions received by members of the Board of Directors, if any, to address or to incorporate, as appropriate, into the return prior to filing. |
| Form 990, Part VI, Line 12c Conflict of interest policy | As part of the Compliance Program at North Flight Aero Med, education, monitoring and enforcement specific to the Conflict of Interest Policy ("COI") and processes are provided. Education regarding COI is provided to all staff and the Board on an annual basis. Annually each NFAM Board Member and the Program Director are required to complete a conflict of interest disclosure/questionnaire. The responses to the disclosure/questionnaire are reviewed by the compliance department and if necessary the compliance committee. Any financial arrangements/potential conflicts identified through the disclosure/questionnaires are presented to legal counsel for review. When an action item is considered by a Board member which involves a potential conflict by a Board member, the conflict is disclosed and a Board member may make a presentation, but shall leave the meeting during discussion and will abstain from a vote on the action item, and, in addition, the Board Chair has the discretion/authority to request that the conflicted Board member be excused from the meeting for an opportunity for the Board to discuss the matter without the presence of the conflicted Board member. Excerpt From the Conflict of Interest Policy Duty to Disclose Conflict Prior to Board or Committee Consideration: In connection with any actual or possible conflict of interest and in addition to the annual statement disclosures set forth in Article VI below, an interested person must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of committees with governing board delegated powers considering the proposed transaction or arrangement. Determining Whether a Conflict of Interest Exists: After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. Procedures for Addressing the Conflict of Interest: - An interested person may make a presentation at the governing board or committee meeting, but after the presentation, he/she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement involving the possible conflict of interest. - The chairperson of the governing board or committee shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. - After exercising due diligence, the governing board or committee shall determine whether the Organization can obtain with reasonable efforts a more advantageous transaction or arrangement from a person or entity that would not give rise to a conflict of interest. - If a more advantageous transaction or arrangement is not reasonably possible under circumstances not producing a conflict of interest, the governing board or committee shall determine by a majority vote of the disinterested directors whether the transaction or arrangement is in the Organization's best interest, for its own benefit, and whether it is fair and reasonable. In conformity with the above determination it shall make its decision as to whether to enter into the transaction or arrangement. Violations of the Conflicts of Interest Policy: - If the governing board or committee has reasonable cause to believe a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. - If, after hearing the member's response and after making further investigation as warranted by the circumstances, the governing board or committee determines the member has failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. The minutes of the governing board and all committees with board delegated powers shall contain: - The names of the persons who disclosed or otherwise were found to have a financial interest in connection with an actual or possible conflict of interest, the nature of the financial interest, any action taken to determine whether a conflict of interest was present, and the governing board's or committee's decision as to whether a conflict of interest in fact existed. - The names of the persons who were present for discussions and votes relating to the transaction or arrangement, the content of the discussion, including any alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection with the proceedings. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization's Articles of Incorporation have been provided to the State of Michigan and are available to the public on the State's website. The organization's Bylaws and internal policies are generally not made available to the public. |
| Form 990, Part IX, Line 11g Other Fees | Leased Employees - Total Expense: 108174, Program Service Expense: , Management and General Expenses: 108174, Fundraising Expenses: ; Other Professional Services - Total Expense: 19497, Program Service Expense: , Management and General Expenses: 19497, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Members' Contributed Capital - 500; |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |