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← CARELINK OF JACKSON A COMMUNITY-OWNED SPECIALTY HOSPITAL

Form 990 for tax year 2023

Filed by CARELINK OF JACKSON A COMMUNITY-OWNED SPECIALTY HOSPITAL.

Totals

Total revenue
$1
Total expenses
$137,119
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$1
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$3,520,770
Net assets or fund balances, end of year
-$3,520,770
Program services expenses (Part IX)
$137,119
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$137,119

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 $1 · excluded $1

Functional expenses

Part IX, the statement of functional expenses.

  • 11g · Fees: other

    total $15,114 · program services $15,114

  • 13 · Office expenses

    total $2,124 · program services $2,124

  • 16 · Occupancy

    total $76,495 · program services $76,495

  • 24a · Other expenses: OTHER DEDUCTIONS

    total $38,296 · program services $38,296

  • 24b · Other expenses: REPAIRS AND MAINTENANCE

    total $5,090 · program services $5,090

Balance sheet

Part X, book values.

  • 4 · Accounts receivable

    beginning of year $20,077

  • 17 · Accounts payable and accrued expenses

    beginning of year $8,579 · end of year $6,989

  • 25 · Other liabilities

    beginning of year $3,395,150 · end of year $3,513,781

  • 27 · Net assets without donor restrictions

    beginning of year -$3,383,652 · end of year -$3,520,770

Mission and programs · 2023

Mission

HENRY FORD ALLEGIANCE SPECIALTY HOSPITAL IS COMMITTED TO HOLISTIC CARE OF INDIVIDUALS WITH COMPLEX MEDICAL NEEDS.

Activities or mission (Part I)

TO PROVIDE LONG-TERM ACUTE HEALTHCARE TO THE RESIDENTS OF JACKSON, MI AND SURROUNDING AREAS.

  • THE LAST PATIENT OF HENRY FORD ALLEGIANCE SPECIALTY HOSPITAL (HFASH) WAS DISCHARGED IN APRIL 2020. ITS MEDICARE CONTRACT WITH THE CMS WAS VOLUNTARILY TERMINATED IN MARCH 2021 EFFECTIVELY CLOSING LONG-TERM ACUTE CARE HOSPITAL OPERATIONS AT THE FACILITY. THE HFASH GOVERNING BOARD FORMALLY AUTHORIZED THE PERMANENT CLOSURE OF HFASH OPERATIONS IN JULY 2021. THE MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS APPROVED THE HFASH PLAN OF CLOSURE EFFECTIVE SEPTEMBER 30, 2021. THE BUILDING IS CURRENTLY FOR SALE. THE ACUTE CARE HOSPITAL LICENSE WAS VOLUNTARILY SURRENDERED.

    Expenses $137,119

As filed on the 2023 return.

Listed in Part VII

  • WENDY KIM

    TRUSTEE-SECRETARY/TREASURE

    Total calculated
    $381,650
    From this org
    $0
    From related orgs
    $372,231
    Other
    $9,419
    Hours/week
    2 + 61 related

    Schedule J breakdown matched by us

    Base
    $0 + $294,618 related
    Bonus
    $0 + $61,011 related
    Other
    $0 + $16,602 related
    Deferred
    $0 + $4,472 related
    Nontaxable benefits
    $0 + $4,947 related
    Filer's total
    $0 + $381,650 related

  • EMILY S MOORHEAD

    TRUSTEE-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

  • SUSAN DECKER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • BRUCE A INOSENCIO JR

    TRUSTEE-CHAIRPERSON

    Total calculated
    $0
    Hours/week
    2

  • RAMI KHOURY MD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • MELISSA STROEDE

    TRUSTEE- VICE CHAIRPERSON

    Total calculated
    $0
    Hours/week
    2

  • SANDRA PLACE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 1 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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
THE FOLLOWING HENRY FORD ALLEGIANCE SPECIALTY HOSPITAL TRUSTEES PARTICIPATED IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN THROUGH THEIR EMPLOYMENT AS OFFICERS OF W.A. FOOTE MEMORIAL HOSPITAL DBA HENRY FORD HEALTH JACKSON HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION. THE CALENDAR YEAR 2023 CONTRIBUTION AND DISTRIBUTION AMOUNTS ARE AS FOLLOWS: CONTRIBUTIONS TO 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 EMILY MOORHEAD 900 - - 900 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) - W.A. FOOTE MEMORIAL HOSPITAL PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 WENDY KIM 12,990 - - 12,990 EMILY MOORHEAD - - 45,654 - 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

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
202413179349302146

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