Totals
- Total revenue
- $2,898
- Total expenses
- $3,628
- Contributions and grants received
- $2,898
- Grants paid
- $0
- Program services expenses (Part IX)
- $3,628
- Management and general expenses
- $0
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $3,628
Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
ROBERT G RINEY
TRUSTEE -CHAIR
- Total calculated
- $3,051,952
- From this org
- $0
- From related orgs
- $2,993,892
- Other
- $58,060
- Hours/week
- 2 + 63 related
Schedule J breakdown matched by us
- Base
- $0 + $1,617,376 related
- Bonus
- $0 + $808,535 related
- Other
- $0 + $567,981 related
- Deferred
- $0 + $29,223 related
- Nontaxable benefits
- $0 + $28,837 related
- Filer's total
- $0 + $3,051,952 related
-
ROBIN S DAMSCHRODER
TRUSTEE-TREASURER
- Total calculated
- $2,780,207
- From this org
- $0
- From related orgs
- $2,718,752
- Other
- $61,455
- Hours/week
- 2 + 63 related
Schedule J breakdown matched by us
- Base
- $0 + $1,020,039 related
- Bonus
- $0 + $693,870 related
- Other
- $0 + $1,004,843 related
- Deferred
- $0 + $26,173 related
- Nontaxable benefits
- $0 + $35,282 related
- Filer's total
- $0 + $2,780,207 related
-
SCOTT A DULCHAVSKY MD PHD
TRUSTEE - PRESIDENT
- Total calculated
- $1,176,906
- From this org
- $0
- From related orgs
- $1,113,900
- Other
- $63,006
- Hours/week
- 2 + 60 related
Schedule J breakdown matched by us
- Base
- $0 + $859,140 related
- Bonus
- $0 + $219,289 related
- Other
- $0 + $35,471 related
- Deferred
- $0 + $29,223 related
- Nontaxable benefits
- $0 + $33,783 related
- Filer's total
- $0 + $1,176,906 related
-
RICHARD O DAVIS PHD
TRUSTEE (THRU 3/2022)
- Total calculated
- $663,726
- From this org
- $0
- From related orgs
- $655,928
- Other
- $7,798
- Hours/week
- 1 + 61 related
Schedule J breakdown matched by us
- Base
- $0 + $110,458 related
- Bonus
- $0 + $541,159 related
- Other
- $0 + $4,311 related
- Deferred
- $0 + $2,056 related
- Nontaxable benefits
- $0 + $5,742 related
- Filer's total
- $0 + $663,726 related
-
STEVEN N KALKANIS MD
TRUSTEE
- Total calculated
- $1,972,081
- From this org
- $0
- From related orgs
- $1,676,555
- Other
- $295,526
- Hours/week
- 1 + 61 related
Schedule J breakdown matched by us
- Base
- $0 + $1,005,242 related
- Bonus
- $0 + $590,763 related
- Other
- $0 + $80,550 related
- Deferred
- $0 + $264,563 related
- Nontaxable benefits
- $0 + $30,963 related
- Filer's total
- $0 + $1,972,081 related
-
ABHILASHA PRASAD
TRUSTEE
- Total calculated
- $550,976
- From this org
- $0
- From related orgs
- $513,463
- Other
- $37,513
- Hours/week
- 1 + 60 related
Schedule J breakdown matched by us
- Base
- $0 + $388,837 related
- Bonus
- $0 + $120,169 related
- Other
- $0 + $4,457 related
- Deferred
- $0 + $5,338 related
- Nontaxable benefits
- $0 + $32,175 related
- Filer's total
- $0 + $550,976 related
-
MICHELLE JOHNSON TIDJANI ESQ
SECRETARY
- Total calculated
- $1,721,328
- From this org
- $0
- From related orgs
- $1,660,930
- Other
- $60,398
- Hours/week
- 2 + 63 related
Schedule J breakdown matched by us
- Base
- $0 + $896,512 related
- Bonus
- $0 + $479,115 related
- Other
- $0 + $285,303 related
- Deferred
- $0 + $26,173 related
- Nontaxable benefits
- $0 + $34,225 related
- Filer's total
- $0 + $1,721,328 related
-
MARJORIE A STATEN JD
ASSISTANT SECRETARY
- Total calculated
- $226,160
- From this org
- $0
- From related orgs
- $212,050
- Other
- $14,110
- Hours/week
- 2 + 58 related
Schedule J breakdown matched by us
- Base
- $0 + $175,106 related
- Bonus
- $0 + $35,360 related
- Other
- $0 + $1,584 related
- Deferred
- $0 + $3,119 related
- Nontaxable benefits
- $0 + $10,991 related
- Filer's total
- $0 + $226,160 related
-
WILLIAM A CONWAY MD
FORMER TRUSTEE
- Total calculated
- $203,850
- From this org
- $0
- From related orgs
- $166,393
- Other
- $37,457
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $166,393 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $14,535 related
- Nontaxable benefits
- $0 + $22,922 related
- Filer's total
- $0 + $203,850 related
-
CARLADENISE A EDWARDS PHD
FORMER TRUSTEE
- Total calculated
- $1,342,637
- From this org
- $0
- From related orgs
- $1,314,538
- Other
- $28,099
- Hours/week
- 0 + 61 related
Schedule J breakdown matched by us
- Base
- $0 + $563,879 related
- Bonus
- $0 + $379,836 related
- Other
- $0 + $370,823 related
- Deferred
- $0 + $5,338 related
- Nontaxable benefits
- $0 + $22,761 related
- Filer's total
- $0 + $1,342,637 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 1a · First-class or charter travel
- 1a · Tax indemnification and gross-up payments
- 1a · Health or social club dues or initiation fees
- 1b · Written policy on the line-1a expenses
- 2 · Substantiation required before reimbursing expenses
- 3 · Compensation committee
- 3 · Independent compensation consultant
- 3 · Written employment contract
- 3 · Compensation survey or study
- 3 · Approval by the board or compensation committee
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 1A
- IT IS THE ORGANIZATION'S POLICY TO PAY OR REIMBURSE EMPLOYEES FOR BONAFIDE BUSINESS TRAVEL BASED ON THE MOST COST EFFECTIVE MEANS AVAILABLE. GENERALLY, WHEN AIR TRAVEL IS INVOLVED THIS EQUATES TO COACH CLASS AIR FARE. UNDER CERTAIN CIRCUMSTANCES, SUCH AS WHEN COACH CLASS IS NOT AVAILABLE OR THE TRIP IS OF AN EXTENSIVE DURATION, SENIOR LEADERSHIP HAS APPROVED BUSINESS CLASS, FIRST CLASS OR CHARTER TRAVEL. IN SUCH CIRCUMSTANCES, THE TRAVEL IS CONSIDERED TO BE FOR A BONAFIDE BUSINESS PURPOSE; ACCORDINGLY, NO TAXABLE INCOME IS REPORTED. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP RECEIVE MEMBERSHIP TO SOCIAL CLUBS INTENDED TO FURTHER THE BUSINESS NEEDS OF THE ORGANIZATION. USAGE IS REIMBURSED ON A CASE-BY-CASE BASIS BASED UPON DOCUMENTATION OF BUSINESS PURPOSE. IN CONNECTION WITH THE RECRUITMENT AND EMPLOYMENT OF LEADERS AND PHYSICIANS, THE ORGANIZATION AGREES AT TIMES TO PROVIDE TEMPORARY HOUSING AND RELOCATION SERVICES. INTERNAL REVENUE SERVICE GUIDELINES ARE ADHERED TO REGARDING THE REPORTING AND TAXATION OF ALL SUCH ITEMS. THE VALUE OF SUCH SERVICES IS ALSO INCLUDED IN THE EVALUATION OF REASONABLE COMPENSATION. CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PROGRAM THAT RESULTS IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. THE ORGANIZATION ALSO OFFERS CERTAIN MEMBERS OF LEADERSHIP THE OPTION OF PARTICIPATING IN AN IRC SEC 457 BENEFIT PROGRAM WHICH ALSO RESULTS IN REPORTABLE TAXABLE INCOME AS BENEFITS ACCRUE, RATHER THAN AS THEY ARE PAID. IT IS AN ELEMENT OF THE PLAN DESIGN TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. SEE Q. 4B FOR THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS.
- PART I, LINES 4A-B
- SCH J, PERSONS PARTICIPATING IN HFHS NONQUALIFIED RETIREMENT PLANS PART I, LINES 4A: SEVERANCE PAYMENTS CARLADENISE EDWARDS, PH.D $250,195 SEC 457 (F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) VALUE OF 2022 TAXABLE 2022 NONTAXABLE 2022 REPORTABLE ACCRUAL DISTRIBUTIONS DISTRIBUTIONS NON-VESTED W-2 AMTS PARTICIPANT ROBERT G. RINEY 463,649 - - - 463,649 MICHELLE JOHNSON TIDJANI 211,041 - - - 211,041 STEVEN KALKANIS, M.D. - - 236,866 - ROBIN DAMSCHRODER 827,133 - - - 827,133 CARLADENISE EDWARDS - 105,509 - - 105,509 CONTRIBUTIONS TO SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2022 CONTRIBUTIONS 2022 CONTRIBUTIONS TAX GROSS-UP W-2 AMOUNTS SCOTT DULCHAVSKY,M.D. - 20,500 493 20,993 ROBERT RINEY 20,500 - - 20,500 ROBIN DAMSCHRODER 20,500 - - 20,500 RICHARD DAVIS 3,154 - - 3,154 STEVEN KALKANIS 20,500 - - 20,500 MICHELLE JOHNSON TIDJANI 20,500 - - 20,500 CARLADENISE EDWARDS 13,404 - - 13,404 LISA PRASAD - 3,345 80 3,425
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
501(C)(3) · HEALTHCARE SERVICE PROVIDER · MI
-
501(C)(3) · HEALTHCARE SERVICE PROVIDER · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
HENRY FORD MACOMB HOSPITAL CORPORATION
501(C)(3) · HEALTHCARE SERVICE PROVIDER · DE · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
501(C)(4) · HEALTH MAINTENANCE ORGANIZATION · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
HENRY FORD HEALTH SYSTEM FOUNDATION
501(C)(3) · SUPPORTING ORGANIZATION · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
HENRY FORD HEALTH SYSTEM GOVERMENT AFFAIRS SERVICES
501(C)(4) · ADVOCACY SERVICES FOR HF HEALTH AND AFFILIATES · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
HENRY FORD ALLEGIANCE HEALTH GROUP
501(C)(3) · EXEMPT ORGANIZATION · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
501(C)(3) · SUPPORTING ORGANIZATION · MI · controlled entity
Directly controlled by HENRY FORD ALLEGIANCE HEALTH GROUP
-
HOSPICE OF JACKSON DBA ALLEGIANCE HOSPICE
501(C)(3) · HOSPICE CARE · MI · controlled entity
Directly controlled by HEALTHLINK
-
501(C)(3) · HOME HEALTH CARE · MI · controlled entity
Directly controlled by HENRY FORD ALLEGIANCE HEALTH GROUP
-
501(C)(3) · LONG TERM ACUTE CARE HOSPITAL · MI · controlled entity
Directly controlled by HENRY FORD ALLEGIANCE HEALTH GROUP
-
WA FOOTE HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL
501(C)(3) · HEALTHCARE SERVICE PROVIDER · MI · controlled entity
Directly controlled by HENRY FORD ALLEGIANCE HEALTH GROUP
-
THE CLARENCE S LIVINGOOD LECTURESHIP AND EDUCATION FUND
501(C)(3) · SUPPORTING ORGANIZATION · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
-
501(C)(3) · PHYSICIAN SERVICES · MI · controlled entity
Directly controlled by HENRY FORD HEALTH SYSTEM
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 10 November 2023
- IRS schema version
- 2022v5.0
- Source object
- 202333149349303683
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
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