| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 | |||||
| (A)
HENRY FORD ALLEGIANCE HEALTH |
382027689 | 3 | Yes | 0 | 0 | |
| (B)
HENRY FORD ALLEGIANCE HOSPICE |
382336367 | 7 | Yes | 0 | 0 | |
| (C)
HENRY FORD ALLEGIANCE CARELINK |
381218485 | 3 | Yes | 0 | 0 | |
|
Total 3
|
0 | 0 | ||||
| Calendar year (or fiscal year beginning in) | (a) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") | ||||||
| 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 | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6 | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 | ||||||
| c | Add lines 10a and 10b | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6Total annual distributions. Add lines 1 through 5. | 6 | |
|
7
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
7 | |
| 8 Distributable amount for 2025 from Section C, line 6 | 8 | |
| 9 Line 7 amount divided by Line 8 amount | 9 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2025 |
(iii) Distributable Amount for 2025 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2025 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2025 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2025: | ||||
| a From 2020....... | ||||
| b From 2021....... | ||||
| c From 2022....... | ||||
| d From 2023....... | ||||
| e From 2024....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2025 distributable amount | ||||
|
i
Carryover from 2020 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2025 from Section D, line 6: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2025 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2025, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2025. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2026. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2021..... | ||||
| b Excess from 2022..... | ||||
| c Excess from 2023..... | ||||
| d Excess from 2024..... | ||||
| e Excess from 2025..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 3 | ALLEGIANCE HEALTH FOUNDATION FILED A CERTIFICATE OF DISSOLUTION EFFECTIVE APRIL 30, 2025. |
| FORM 990, PART VI, SECTION A, LINE 2 | TRUSTEE TO TRUSTEE BUSINESS RELATIONSHIP: CARRIE GLICK(BOARD MEMBER) AND JAY ZIEMBA ( BOARD MEMBER). |
| FORM 990, PART VI, SECTION A, LINE 4 | HENRY FORD ALLEGIANCE HEALTH FOUNDATION ("HFAF") FILED A CERTIFICATE OF DISSOLUTION EFFECTIVE APRIL 30, 2025 |
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION IS ORGANIZED ON A MEMBERSHIP BASIS. THE SOLE CORPORATE MEMBER OF THE CORPORATION IS HENRY FORD ALLEGIANCE HEALTH GROUP (FORMERLY ALLEGIANCE HEALTH SERVICES). HENRY FORD ALLEGIANCE HEALTH GROUP IS A TAX-EXEMPT HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | APPROVE CHANGES IN THOSE PROVISIONS OF THE CORPORATION'S BYLAWS WHICH AFFECT THE SIZE, COMPOSITION, AND METHOD OF SELECTION OF THE BOARD OF DIRECTORS, OR WHICH AFFECT THIS ARTICLE; EFFECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CORPORATION'S DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE CORPORATE MEMBER OF THE CORPORATION IS HENRY FORD ALLEGIANCE HEALTH GROUP ("MEMBER"). THE MEMBER'S SOLE CORPORATE MEMBER IS HENRY FORD HEALTH SYSTEM DBA HENRY FORD HEALTH ("HF HEALTH"). HF HEALTH SHALL HAVE THE SOLE AUTHORITY TO TAKE OR CAUSE TO BE TAKEN ANY OF THE FOLLOWING ACTIONS (THE "HF HEALTH'S RESERVED POWERS"). APPOINT THE BOARD OF DIRECTORS, CHAIRPERSON, AND PRESIDENT OF THE CORPORATION AND ITS SUBSIDIARIES. REMOVE THE BOARD OF DIRECTORS, CHAIRPERSON AND PRESIDENT OF THE CORPORATION AND ITS SUBSIDIARIES. CHANGE THE CORPORATE MEMBER OF THE CORPORATION OR ITS SUBSIDIARIES, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS. AMEND THESE BYLAWS, THE CORPORATION'S ARTICLES OF INCORPORATION OR THE GOVERNING DOCUMENTS OF THE CORPORATION'S SUBSIDIARIES, PROVIDED HF HEALTH FIRST CONSULTS WITH THE MEMBER'S BOARD OF DIRECTORS REGARDING THE PROPOSED AMENDMENT. APPROVE AN AGREEMENT OF (A) MERGER OR CONSOLIDATION OF THE CORPORATION OR ITS SUBSIDIARIES, OR (B) SALE, LEASE, OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR ITS SUBSIDIARIES, PROVIDED SUCH AGREEMENT SHALL HAVE BEEN APPROVED BY VOTE OF TWO-THIRDS OF THE MEMBER'S LOCAL DIRECTORS (AS DEFINED IN THE MEMBER'S BYLAWS) AND FURTHER PROVIDED THAT APPROVAL OF THE LOCAL DIRECTORS SHALL NOT BE REQUIRED WITH RESPECT TO CERTAIN TRANSACTIONS WITH RESPECT TO HF HEALTH'S OVERALL HEALTH SYSTEM (INCLUDING THE SYSTEM) AS DESCRIBED IN SECTION 6.8(B) OF THE AFFILIATION AGREEMENT DATED MARCH 4, 2016 BETWEEN THE MEMBER (THEN KNOWN AS ALLEGIANCE HEALTH SERVICES) AND HF HEALTH, AS AMENDED FROM TIME TO TIME. DISSOLVE THE CORPORATION OR ITS SUBSIDIARIES OR REVOKE SUCH DISSOLUTION, PROVIDED SUCH ACTION SHALL HAVE BEEN APPROVED BY A VOTE OF THE MEMBER'S BOARD OF DIRECTORS. CAUSE THE CORPORATION AND ITS SUBSIDIARIES TO INCUR, ASSUME OR GUARANTY INDEBTEDNESS OR FULFILL OTHER OBLIGATIONS REQUIRED UNDER HF HEALTH DEBT AGREEMENTS. ENCUMBER THE ASSETS OF THE CORPORATION AND ITS SUBSIDIARIES AS SECURITY FOR DEBTS OR OTHER LAWFUL ENGAGEMENTS SECURING INDEBTEDNESS. AUTHORIZE THE FORMATION OR ACQUISITION OF NEW SUBSIDIARIES OF THE CORPORATION FOLLOWING CONSULTATION WITH THE MEMBER'S BOARD OF DIRECTORS. AS USED HEREIN, "INDEBTEDNESS" OF A PERSON SHALL MEAN: (A) OBLIGATIONS OF SUCH PERSON RELATING TO INDEBTEDNESS FOR BORROWED MONEY; (B) OBLIGATIONS OF SUCH PERSON EVIDENCED BY BONDS, NOTES, DEBENTURES OR SIMILAR INSTRUMENTS; AND (C) OBLIGATIONS IN THE NATURE OF GUARANTEES BY, OR JOINT AND SEVERAL LIABILITY OF, SUCH PERSON WITH RESPECT TO THE OBLIGATIONS OF ANY OTHER PERSON OF THE TYPE DESCRIBED IN CLAUSES (A) AND (B) ABOVE. RESPONSIBILITIES AND RESERVED POWERS OF THE MEMBER (HENRY FORD ALLEGIANCE HEALTH GROUP). IN ADDITION TO DOING ALL THINGS RESERVED TO THE MEMBER BY LAW, THE MEMBER OF THE CORPORATION SHALL HAVE SOLE AUTHORITY TO TAKE THE FOLLOWING ACTIONS WITH RESPECT TO THIS CORPORATION ("MEMBER'S RESERVED POWERS"), SUBJECT HOWEVER TO HF HEALTH'S RESERVED POWERS: ADOPT THE VISION, MISSION AND VALUES. ADOPT THE CORPORATION'S OPERATING AND CAPITAL BUDGETS AND APPROVE ANY NON-BUDGETARY EXPENDITURES IN EXCESS OF MAXIMUM LIMITS ESTABLISHED BY THE MEMBER, APPROVE ANY CHANGE IN THE METHOD OF DISTRIBUTION, OR THE CLASS OF BENEFICIARIES RECEIVING, FUNDS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) AND THE TAX DEPARTMENT OF HF HEALTH PREPARES THE ORGANIZATION'S FORM 990. AS PART OF THE PREPARATION AND REVIEW PROCESS PRIOR TO FILING THE RETURN, THE FOLLOWING REVIEW PROCESS IS CONDUCTED: - REVIEW OF THE ENTIRE RETURN WITH THE HF HEALTH AND ORGANIZATION'S SENIOR VICE PRESIDENT FINANCIAL OPERATIONS, CHIEF FINANCIAL OFFICER AND DIRECTOR OF ACCOUNTING. - REVIEW OF ALL COMPENSATION MATTERS AND DISCLOSURES WITH THE COMPENSATION COMMITTEE OF THE HF HEALTH BOARD OF DIRECTORS - REVIEW OF THE RETURN WITH THE HF HEALTH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS, INCLUDING THE CEO - FINAL COPIES OF THE RETURN ARE DISTRIBUTED TO THE FOUNDATION'S BOARD OF DIRECTORS BEFORE THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) WHO OVERSEES THE CONFLICT OF INTEREST PROCESS WITH REGARD TO THE ORGANIZATION. HF HEALTH HAS A STANDING CONFLICT OF INTEREST COMMITTEE (THE COMMITTEE) THAT IS RESPONSIBLE FOR OVERSIGHT OF ALL CONFLICT OF INTEREST MATTERS. THE HF HEALTH CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS AND EMPLOYEES. ANNUALLY, DIRECTORS, EMPLOYEES OF A MANAGEMENT LEVEL, RESEARCHERS, AS WELL AS EMPLOYEES ASSOCIATED WITH PROCUREMENT, OR IN CERTAIN OTHER PREDEFINED ROLES MUST COMPLETE AN ANNUAL DISCLOSURE DESIGNED TO IDENTIFY ACTIVITIES AND RELATIONSHIPS THAT COULD POTENTIALLY GIVE RISE TO A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE COMMITTEE TO REVIEW THESE DISCLOSURES AND DETERMINE THE NEED FOR ANY ACTION TO MANAGE THE POTENTIAL CONFLICT. THE COMMITTEE ANNUALLY REPORTS THE RESULTS OF ITS ACTIVITIES TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE HF HEALTH BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION IS AN AFFILIATE OF HENRY FORD HEALTH (HF HEALTH) WHO HAS RESPONSIBILITY TO OVERSEE THE COMPENSATION PRACTICES OF THE ORGANIZATION. HF HEALTH HAS A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS CONSISTING OF ALL EXTERNAL DIRECTORS. THEY MEET PERIODICALLY THROUGHOUT THE YEAR. THEY ARE CHARGED WITH APPROVAL OF THE ORGANIZATION'S OVERALL COMPENSATION AND BENEFIT PROGRAMS AS WELL AS THE SPECIFIC REVIEW AND APPROVAL OF THE COMPENSATION OF CERTAIN EMPLOYEES INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THEY DIRECTLY ENGAGE AN INDEPENDENT COMPENSATION ADVISOR TO ASSIST WITH THIS PROCESS. THE PROCESS INCLUDES EVALUATION OF THE INDIVIDUAL'S PERFORMANCE, UTILIZATION OF COMPENSATION STUDIES OF SIMILARLY SITUATED POSITIONS, AS WELL AS COMPARISONS TO COMPENSATION AS REPORTED BY OTHER HEALTH CARE ORGANIZATIONS. THE REASONABLENESS OF COMPENSATION IS EVALUATED BASED UPON THESE AND OTHER FACTORS. THE COMMITTEE ALSO REVIEWS THE COMPENSATION DISCLOSURES TO BE MADE ON FORM 990 IN ADVANCE OF FILING. |
| FORM 990, PART VI, SECTION C, LINE 19 | IT IS THE PRACTICE OF THE ORGANIZATION TO MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO ANY PARTY REQUESTING SUCH INFORMATION. |
| FORM 990, PART XI, LINE 9: | CAPTIAL CONTRIBUTION FROM HENRY FORD ALLEGIANCE HEALTH GROUP 165,916. |
| FORM 5713- INTERNATIONAL BOYCOTT ACTIVITIES: | A FORM 5713, INTERNATIONAL BOYCOTT REPORT, HAS BEEN FILED ON OUR BEHALF BY HENRY FORD HEALTH (PARENT OF CONTROLLED GROUP OF WHICH THE ORGANIZATION IS A MEMBER). THE ORGANIZATION DID NOT ITSELF HAVE ANY ACTIVITIES ASSOCIATED WITH AN INTERNATIONAL BOYCOTT COUNTRY. |
| FORM 990, PART XII, LINE 2C | HENRY FORD ALLEGIANCE HEALTH FOUNDATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF HENRY FORD HEALTH (THE SOLE MEMBER OF HENRY FORD ALLEGIANCE HEALTH GROUP). THE GOVERNING BODY OF HENRY FORD ALLEGIANCE HEALTH HAS DELEGATED THE OVERSIGHT OF ITS FINANCIAL STATEMENTS, INCLUDING THE CHOICE OF INDEPENDENT AUDITORS, TO ITS AUDIT COMMITTEE. |
| FORM 990, PART VII: | AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: MANY EXECUTIVE EMPLOYEES OF HENRY FORD HEALTH AND AFFILIATES PROVIDE SERVICES TO MULTIPLE AFFILIATED ENTITIES. HENRY FORD HEALTH AND AFFILIATES USE ESTIMATES FOR REPORTING AVERAGE HOURS PER WEEK IN ALL SECTIONS OF FORM 990. GENERALLY 60 HOURS ARE REPORTED FOR THE HOURS ASSOCIATED FOR THE ORGANIZATION THAT THE INDIVIDUAL HAS PRINCIPAL RESPONSIBILITY FOR. HOURS ASSOCIATED WITH OTHER HOSPITALS OR AFFILIATES ARE REPORTED AT BETWEEN 1 TO 5 HOURS PER WEEK. |
| FORM 990, PART IV, LINE 12 | THE ORGANIZATION IS AN ELEMENT OF THE EXTERNAL AUDIT REPORT OBTAINED FOR THE CONSOLIDATED OPERATIONS OF HENRY FORD HEALTH. |
| Software ID: | |
| Software Version: |