Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (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)
MYMICHIGAN MEDICAL CENTER TAWAS |
381443395 | 3 | Yes | 221,769 | 0 | |
|
Total 1
|
221,769 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. 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 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | IN AUGUST 2024, MYMICHIGAN MEDICAL CENTER TAWAS ("THE MEMBER"), FORMERLY KNOWN AS ASCENSION ST. JOSEPH HOSPITAL, BECAME THE SOLE MEMBER OF MYMICHIGAN MEDICAL CENTER TAWAS FOUNDATION (THE "CORPORATION"), FORMERLY KNOWN AS ASCENSION ST. JOSEPH FOUNDATION. MYMICHIGAN HEALTH ("THE PARENT ORGANIZATION") IS THE SOLE MEMBER OF MYMICHIGAN MEDICAL CENTER TAWAS. WITH THE FOLLOWING EXCEPTIONS, THE NEW BYLAWS FOR THE CORPORATION ARE LARGELY CONSISTENT WITH THE FORMER. ALL REFERENCES TO THE ROMAN CATHOLIC CHURCH HAVE BEEN ELIMINATED. THE PARENT ORGANIZATION OF THE MEMBER HAS CERTAIN APPROVED RESERVED POWERS, INCLUDING THE POWER TO APPROVE THE CORPORATION'S BUDGET, THE INCURRENCE OF DEBT, CAPITAL EXPENDITURES, AND GIFTS MORE THAN $2,000,000. THE MINIMUM NUMBER OF DIRECTORS FOR THE CORPORATION INCREASED FROM 3 TO 9, AND THE MAXIMUM NUMBER DECREASED FROM 25 TO 14. THE PARENT ORGANIZATION'S CEO SERVES AS THE PRESIDENT OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION AND THE PRESIDENT OF THE MEMBER EACH SERVE AS EX-OFFICIO DIRECTORS. TWO THIRDS OF THE DIRECTORS SHALL BE DIRECTORS WHO ARE NOT EMPLOYEES OF THE PARENT ORGANIZATION OR ITS SUBSIDIARIES. A DIRECTOR IS ELECTED BY THE PARENTING ORGANIZATION WITH THE AGREEMENT OF THE CORPORATION AND MAY BE REMOVED BY THE PARENT ORGANIZATION AFTER CONSULTATION WITH THE CORPORATION. A VACANCY BY A DIRECTOR SHALL BE FILLED BY THE PARENTING ORGANIZATION WITH THE AGREEMENT OF THE CORPORATION. OFFICERS SHALL BE DIRECTORS WHO ARE NOT EMPLOYEES OF THE PARENT ORGANIZATION OR ITS SUBSIDIARIES AND THE SECRETARY AND THE TREASURER NEED NOT BE A DIRECTOR OF THE CORPORATION. AN OFFICER IS APPOINTED BY THE CORPORATION AND MAY BE REMOVED BY THE CORPORATION OR THE PARENT ORGANIZATION AFTER CONSULTATION WITH THE CORPORATION. A VACANCY BY AN OFFICER SHALL BE FILLED BY THE CORPORATION. DIRECTORS AND COMMITTEE MEMBERS SERVE WITHOUT COMPENSATION. THE CORPORATION SHALL MEET AS DETERMINED BY THE BOARD, WITH SPECIAL MEETINGS CONVENED UPON THE CALL OF THREE DIRECTORS WHO ARE NOT EMPLOYEES OF THE PARENT ORGANIZATION OR ITS SUBSIDIARIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MYMICHIGAN MEDICAL CENTER TAWAS, WHICH IS SOLELY OWNED BY MYMICHIGAN HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MYMICHIGAN HEALTH BOARD OF DIRECTORS ELECTS INDIVIDUALS TO FILL OPEN POSITIONS ON THE CORPORATION'S BOARD OF DIRECTORS, WITH CONCURRENCE FROM THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING RIGHTS AND RESPONSIBILITIES ARE RESERVED TO THE SOLE MEMBER: A) APPROVE ANY CHANGE IN THE CORPORATION'S PURPOSES; B) APPROVE ANY CHANGE IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; C) APPROVE PLANS OF MERGER, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION, JOINT VENTURE, OR THE CREATION BY THE CORPORATION OF ANY CONTROLLED CORPORATION OR OTHER ENTITY; D) APPROVE ANY PROPOSED SALE, TRANSFER, LEASE, PLEDGE, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE PROPOSED SALE, TRANSFER, LEASE, PLEDGE OR ENCUMBRANCE OF ANY ASSET OR ASSETS OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; E) APPROVE THE CORPORATION'S BUDGET AND ANY CAPITAL EXPENDITURES OF THE CORPORATION; F) APPROVE ANY GRANT OR DISTRIBUTION OF CORPORATION'S CHARITABLE ASSETS WHICH EXCEEDS TWO MILLION DOLLARS ($2,000,000) IN A SINGLE TRANSACTION OR SERIES OF RELATED TRANSACTIONS; G) APPROVE THE GUARANTY BY THE CORPORATION OF THE DEBT OF OTHERS; AND H) APPROVE THE INCURRENCE BY THE CORPORATION OF ANY DEBT OR LEASE OBLIGATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE STAFF AT EACH SUBSIDIARY UPLOADS INFORMATION INTO THE SOFTWARE WHICH IS THEN REVIEWED BY THE CORPORATE CONTROLLER AT MYMICHIGAN HEALTH, THE SOLE MEMBER OF THIS CORPORATION. THE CORPORATE CONTROLLER REQUESTS ADDITIONAL INFORMATION AND OBTAINS CLARIFICATION. A FINAL REVIEW IS THEN DONE BY THE SVP AND TREASURER. IN ADDITION, ALL COMPENSATION DISCLOSURES ARE REVIEWED WITH THE MYMICHIGAN HEALTH CEO PRIOR TO FILING. PRIOR TO FILING: THE FORM 990 PART VII AND SCHEDULE J COMPENSATION INFORMATION IS REVIEWED BY THE COMPENSATION COMMITTEE. FORM 990, INCLUDING ALL SCHEDULES, IS MADE AVAILABLE TO THIS ORGANIZATION'S BOARD OF DIRECTORS IN A SECURE ELECTRONIC FORMAT WITH A SUMMARY OF ALL THE MAJOR CHANGES FROM THE PRIOR YEAR RETURN. QUESTIONS OR CONCERNS ARE ADDRESSED BY THE SVP AND TREASURER. THE QUESTIONS OR CONCERNS OF THESE REVIEWS ARE PRESENTED TO THE MYMICHIGAN HEALTH BOARD OF DIRECTORS AND THIS ORGANIZATION'S BOARD OF DIRECTORS, IF ANY ARE IDENTIFIED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE OF THE BOARD ANNUALLY: 1). TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY (THE "POLICY"); 2). TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILIAL, OR BUSINESS RELATIONSHIP THAT REASONABLY COULD GIVE RISE TO A CONFLICT OF INTEREST OR THE APPEARANCE OF A CONFLICT OF INTEREST; AND 3). TO ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS ACTING IN ACCORDANCE WITH THE LETTER AND SPIRIT OF THE POLICY. THE COMPLETED FORMS ARE REVIEWED BY THE MYMICHIGAN HEALTH SECRETARY AND FILED FOR REFERENCE AS NEEDED. A LISTING OF ANY CONFLICTS ARE PROVIDED TO THE BOARD AND PRESIDENT OF THE ORGANIZATION. VOTING BOARD MEMBERS WITH CONFLICTS ON SPECIFIC ISSUES MAY BE ASKED TO LEAVE THE MEETING DURING DISCUSSIONS AND ABSTAIN FROM VOTING ON ANY ISSUE IN WHICH THEY ARE NOT INDEPENDENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | ALL CEOS AND OPERATING OFFICERS COMPENSATION IS ANNUALLY REVIEWED BY AN INDEPENDENT COMPENSATION CONSULTANT FOR REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE OF MYMICHIGAN HEALTH. THE COMPENSATION IS THEN REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS (OR SUBCOMMITTEE THEREOF). |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE OF OWNERSHIP ADJUSTMENT 16,092. |
| Software ID: | |
| Software Version: |