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Nonprofiteer
← HENRY FORD ALLEGIANCE HEALTH GROUP

Form 990 for tax year 2023

Filed by HENRY FORD ALLEGIANCE HEALTH GROUP.

Totals

Total revenue
$220,576
Total expenses
$9,448
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$220,576
Other revenue
$0
Total assets, end of year
$38,061,513
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$38,061,513
Program services expenses (Part IX)
$9,448
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$9,448

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 3 · Investment income

    total $20,609 · excluded $20,609

  • 7a · Gross sales of assets other than inventory

    securities $2,763,019

  • 7b · Less cost or other basis and sales expenses

    securities $2,563,052

  • 7c · Gain or loss

    securities $199,967

  • 7d · Net gain or loss

    total $199,967 · related or exempt $199,967

Functional expenses

Part IX, the statement of functional expenses.

  • 11f · Fees: investment management

    total $9,448 · program services $9,448

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year -$1

  • 11 · Investments: publicly traded securities

    beginning of year $7,304,822 · end of year $8,166,241

  • 13 · Investments: program-related

    beginning of year $29,895,273 · end of year $29,895,273

  • 27 · Net assets without donor restrictions

    beginning of year $37,200,095 · end of year $38,061,513

Mission and programs · 2023

Mission

HENRY FORD ALLEGIANCE HEALTH GROUP OPERATES TO SUPPORT THE CHARITABLE PURPOSE OF W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL ("HFHJH") AND RELATED CHARITABLE ORGANIZATIONS.

Activities or mission (Part I)

SUPPORTS THE CHARITABLE PURPOSE OF W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL.

  • THE ORGANIZATION'S PURPOSE IS TO SUPPORT THE CHARITABLE PURPOSE OF W.A. FOOTE MEMORIAL HOSPITAL (D/B/A HENRY FORD HEALTH JACKSON HOSPITAL) AND RELATED CHARITABLE ORGANIZATION.

    Expenses $9,448 · Revenue $199,967

As filed on the 2023 return.

Listed in Part VII

  • Denise Brooks-Williams

    DIRECTOR

    Total calculated
    $1,689,777
    From this org
    $0
    From related orgs
    $1,641,896
    Other
    $47,881
    Hours/week
    1 + 62 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,054,577 related
    Bonus
    $0 + $317,037 related
    Other
    $0 + $270,282 related
    Deferred
    $0 + $27,441 related
    Nontaxable benefits
    $0 + $20,440 related
    Filer's total
    $0 + $1,689,777 related

  • Aaron S Boatin

    DIRECTOR- SECRETARY/TREASUER

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • David W Craft

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Sairia Dass Ramcharan MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Martha A Fuerstenau

    DIRECTOR-CHAIR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • Catherine A Hendrian

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Mohan G Kulkarni MD

    DIRECTOR

    Total calculated
    $1,158,007
    From this org
    $0
    From related orgs
    $1,103,312
    Other
    $54,695
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $427,575 related
    Bonus
    $0 + $316,135 related
    Other
    $0 + $359,602 related
    Deferred
    $0 + $4,950 related
    Nontaxable benefits
    $0 + $49,745 related
    Filer's total
    $0 + $1,158,007 related

  • Mumtaz A Memonmd

    PHYSICIAN DIRECTOR

    Total calculated
    $715,828
    From this org
    $0
    From related orgs
    $679,300
    Other
    $36,528
    Hours/week
    1 + 61 related

    Schedule J breakdown matched by us

    Base
    $0 + $445,449 related
    Bonus
    $0 + $147,351 related
    Other
    $0 + $86,500 related
    Deferred
    $0 + $4,950 related
    Nontaxable benefits
    $0 + $31,578 related
    Filer's total
    $0 + $715,828 related

  • Emily S Moorhead

    DIRECTOR - PRESIDENT & CEO

    Total calculated
    $584,831
    From this org
    $0
    From related orgs
    $532,832
    Other
    $51,999
    Hours/week
    2 + 63 related

    Schedule J breakdown matched by us

    Base
    $0 + $413,129 related
    Bonus
    $0 + $115,907 related
    Other
    $0 + $3,796 related
    Deferred
    $0 + $50,604 related
    Nontaxable benefits
    $0 + $1,395 related
    Filer's total
    $0 + $584,831 related

  • Monica M Moser

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Adnan R Munkarah MD

    DIRECTOR

    Total calculated
    $2,403,542
    From this org
    $0
    From related orgs
    $2,335,257
    Other
    $68,285
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,372,925 related
    Bonus
    $0 + $523,983 related
    Other
    $0 + $438,349 related
    Deferred
    $0 + $27,441 related
    Nontaxable benefits
    $0 + $40,844 related
    Filer's total
    $0 + $2,403,542 related

  • Lawrence Narkiewicz Jr MD

    PHYSICIAN DIRECTOR

    Total calculated
    $627,025
    From this org
    $0
    From related orgs
    $591,213
    Other
    $35,812
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $378,378 related
    Bonus
    $0 + $29,194 related
    Other
    $0 + $183,641 related
    Deferred
    $0 + $5,655 related
    Nontaxable benefits
    $0 + $30,157 related
    Filer's total
    $0 + $627,025 related

  • Mark S Olson

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Kevin E Oxley

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Samir Parikh MD

    DIRECTOR

    Total calculated
    $57,262
    From this org
    $0
    From related orgs
    $57,262
    Other
    $0
    Hours/week
    1 + 1 related

  • Daniel J Phelan PhD

    DIRECTOR- VICE CHAIR

    Total calculated
    $30,000
    From this org
    $0
    From related orgs
    $30,000
    Other
    $0
    Hours/week
    2 + 6 related

  • Christina M Siders

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Paula Autry

    FORMER DIRECTOR - PRESIDENT & CEO

    Total calculated
    $368,899
    From this org
    $0
    From related orgs
    $368,899
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $368,899 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $368,899 related

  • Robert G Riney

    FORMER DIRECTOR

    Total calculated
    $4,524,962
    From this org
    $0
    From related orgs
    $4,467,923
    Other
    $57,039
    Hours/week
    0 + 65 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,165,620 related
    Bonus
    $0 + $1,535,761 related
    Other
    $0 + $766,542 related
    Deferred
    $0 + $27,441 related
    Nontaxable benefits
    $0 + $29,598 related
    Filer's total
    $0 + $4,524,962 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, and on a Form 990-PF Part VIII's — 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
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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
CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN SUPPLEMENTAL RETIREMENT PROGRAMS THAT RESULT IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, AND/OR AS 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. THE FOLLOWING PROVIDES THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS: PART I, LINES 4A: SEVERANCE PAYMENTS PAULA AUTRY $368,899 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) - HENRY FORD HEALTH SYSTEM PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 ROBERT G. RINEY 736,518 - - 736,518 DENISE BROOKS-WILLIAMS 229,220 - - 229,220 ADNAN R. MUNKARAH, M.D. 359,641 - - 359,641 SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - HENRY FORD HEALTH SYSTEM EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2023 CONTR. 2023 CONTR. TAX GROSS-UP W-2 AMOUNTS ROBERT G. RINEY 22,500 - - 22,500 DENISE BROOKS-WILLIAMS 16,900 - - 16,900 ADNAN R. MUNKARAH 22,500 - - 22,500 EMILY MOORHEAD 2,896 - - 2,896 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) -W.A. FOOTE MEMORIAL HOSPITAL PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 EMILY MOORHEAD 45,654 - - 45,654 SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - W.A. FOOTE MEMORIAL HOSPITAL EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2023 CONTR. 2023 CONTR. TAX GROSS-UP W-2 AMOUNTS MOHAN G. KULKARNI, M.D. 16,425 6,075 146 22,646 LAWRENCE NARKIEWICZ, M.D. 19,700 2,800 67 22,567 MUMTAZ MEMON, M.D. 16,550 5,950 143 22,643 EMILY MOORHEAD 900 - - 900

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • FOOTE HEALTH CENTER ASSOCIATES

    RELATED · LESSOR OF MEDICAL CONDOMINIUMS · MI

    Directly controlled by HENRY FORD HEALTH JACKSON HOSPITAL

  • NORTHWEST DETROIT DIALYSIS

    N/A · OPERATE DIALYSIS CLINIC · MI

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • MACOMB REGIONAL DIALYSIS CENTERS

    N/A · OPERATE DIALYSIS CLINIC · MI

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • HFHS-SCA HOLDINGS LLC

    N/A · OUTPATIENT SURGERY CLINICS · MI

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • HAP EMPOWERED HOLDING LLC

    N/A · HOLDING COMPANY · DE

    Directly controlled by HEALTH ALLIANCE PLAN OF MICHIGAN

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • HENRY FORD ALLEGIANCE PHARMACY

    C · PHARMACY · MI · 100% owned · share of income $10,675,653 · share of assets $772,673 · controlled entity

    Directly controlled by HENRY FORD ALLEGIANCE HEALTH GROUP

  • SHA REALTY INC

    C · REAL ESTATE HOLDING · MI · controlled entity

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • FAIRLANE HEALTH SERVICES

    C · HEALTHCARE MANAGEMENT · MI · controlled entity

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • ALLIANCE HEALTH AND LIFE INSURANCE

    C · HEALTH INSURANCE PROVIDER · MI · controlled entity

    Directly controlled by HEALTH ALLIANCE PLAN

  • ONIKA INSURANE LTD

    C · CAPTIVE INSURANCE · CJ · controlled entity

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • HENRY FORD PHYSICIAN NETWORK

    C · PHYSICIAN NETWORK · MI · controlled entity

    Directly controlled by HENRY FORD HEALTH SYSTEM

  • ADMINSTRATION SYSTEMS RESEARCH CORPORATION

    C · THIRD PARTY ADMIN. · MI · controlled entity

    Directly controlled by HEALTH ALLIANCE PLAN

  • HAP CARESOURCE

    C · HEALTH INSURANCE PROVIDER · MI · controlled entity

    Directly controlled by HEALTH ALLIANCE PLAN OF MICHIGAN

  • HENRY FORD ELIJAH MCCOY CONDOMINIUM ASSOCIATION

    T · CONDOMINIUM ASSOCIATION · MI · controlled entity

    Directly controlled by HENRY FORD HEALTH SYSTEM

Provenance

Return type
form_990
Tax year
2023
Filed
12 November 2024
IRS schema version
2023v5.1
Source object
202413179349305411

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