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← ALLEGIANCE HEALTH FOUNDATION

Form 990 for tax year 2023

Filed by ALLEGIANCE HEALTH FOUNDATION.

Totals

Total revenue
$0
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$165,916
Net assets or fund balances, end of year
-$165,916
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

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.

Balance sheet

Part X, book values.

  • 17 · Accounts payable and accrued expenses

    beginning of year $165,916 · end of year $165,916

  • 27 · Net assets without donor restrictions

    beginning of year -$165,916 · end of year -$165,916

Mission and programs · 2023

Mission

THE CORPORATION IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) AND 170(C)(2) OF THE INTERNAL REVENUE CODE OF 1986 AND SHALL HAVE THE FOLLOWING SPECIFC PURPOSES AND POWERS:TO RAISE FUNDS FROM THE PUBLIC AND FROM ALL OTHER SOURCES FOR THE PURPOSES OF FURTHERING THE CHARITABLE PURPOSES OF HENRY FORD ALLEGIANCE HEALTH GROUP AND OTHER SYSTEM ENTITIES, AND IMPROVING THE GENERAL HEALTH AND WELFARE OF RESIDENTS IN AND AROUND JACKSON COUNTY.

Activities or mission (Part I)

THE FOUNDATION SUPPORTS THE CHARITABLE PURPOSE OF HENRY FORD ALLEGIANCE HEALTH GROUP.

  • HENRY FORD ALLEGIANCE HEALTH GROUP IS THE LARGEST ECONOMIC ENGINE, EMPLOYER, HEALTH CARE PROVIDER AND HEALTH-IMPROVER IN THE REGION. THE MISSION OF THE HENRY FORD ALLEGIANCE HEALTH FOUNDATION IS "TO ADVANCE COMMUNITY HEALTH & WELL-BEING BY CREATING LOYAL RELATIONSHIPS AND SECURING SUPPORT FOR OUR HEALTH SYSTEM". DURING FY 2023 DONORS TO HENRY FORD ALLEGIANCE HEALTH GROUP SUPPORTED THE HEALTH SYSTEM IN MANY WAYS. GENERAL, UNRESTRICTED DONATIONS HELPED MEET THE UNFUNDED NEEDS OF OUR PATIENTS, ENABLING OUR CAREGIVERS TO PROVIDE THE VERY BEST CARE TO ALL REGARDLESS OF INSURANCE OR INCOME. PATIENTS AND THEIR FAMILY MEMBERS RECEIVED END-OF-LIFE CARE IN THE HENRY FORD ALLEGIANCE HOSPICE HOME BECAUSE DONORS GAVE TO THE COMMUNITY'S ONLY NOT-FOR-PROFIT HOSPICE. HENRY FORD HEALTH JACKSON HOSPITAL STAFF FACING UTILITY SHUTOFFS, HOME FORECLOSURE, CAR REPOSSESSION OR OTHER FINANCIAL EMERGENCIES WERE SPARED BECAUSE THEIR CO-WORKERS GAVE TO THE STAFF ASSISTANCE FUND FOR EMERGENCIES (SAFE).CHARITABLE GIFTS WILL HELP WOMEN AND CHILDREN IN THE COMMUNITY RECEIVE PREVENTIVE SCREENS, LACTATION SERVICES, EDUCATION, AND ENHANCED PRENATAL CARE.

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • SARAH ERMATINGER

    DIRECTOR-CHAIRMAN

    Total calculated
    $0
    Hours/week
    2

  • SHEILA EVERTS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CARRIE GLICK

    DIRECTOR-SECRETARY/TREASUR

    Total calculated
    $0
    Hours/week
    2

  • JAMIE GRACE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • BRIAN KIMMD

    DIRECTOR

    Total calculated
    $6,000
    From this org
    $0
    From related orgs
    $6,000
    Other
    $0
    Hours/week
    1

  • TERRY LANGSTON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JORDAN LEVY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • FRANK LUSEBRINK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MUMTAZ MEMON MD

    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

  • MARY SHIRKEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CHERYL SIMONETTI

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • SHAWNA TELLO

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JOHN WALDRON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JAY ZIEMBA

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • EMILY S MOORHEAD

    DIRECTOR-PRESIDENT

    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

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 · Tax indemnification and gross-up payments
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4a · Severance or change-of-control payment
  • 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 4B
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 SOME PLAN DESIGNS 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: CONTRIBUTIONS TO 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 EMILY MOORHEAD 2,896 - - 2,896 SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - W.A. FOOTE MEMORIAL HOSPITAL EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2022 CONTR. 2022 CONTR. TAX GROSS-UP W-2 AMOUNTS EMILY MOORHEAD 900 - - 900 MUMTAZ MEMON, M.D. 16,550 5,950 143 22,643 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 -

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
12 November 2024
IRS schema version
2023v5.1
Source object
202403179349305365

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