Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
Spectrum Health System Group Return
 
Employer identification number
61-1740292
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) Cherry Street Health Services
550 Cherry St SE
Grand Rapids,MI49503 		38-2853534 501(c)(3) 300,000       Vision & Dental care
(2) Spectrum Health System
100 Michigan St NE
Grand Rapids,MI49503 		38-3382353 501(c)(3) 191,523       General Support
(3) Access of West Michigan
2850 Kalamazoo SE
Grand Rapids,MI49506 		38-3195190 501(c)(3) 150,000       Food Pantry Assistance for Chronic Health Conditions
(4) Heart of West MI United Way
118 Commerce Ave SW
Grand Rapids,MI49503 		38-1360923 501(c)(3) 146,870       Essential Needs Task Force
(5) Grand Rapids Public Schools
1331 Franklin St SE
Grand Rapids,MI49506 		38-6002019 Governmental Entity 123,333       Health, Science & Technology Program for underserved youth
(6) Health Intervention Services
15 Andre St
Grand Rapids,MI49503 		38-3273825 501(c)(3) 115,806       Medical Care Services
(7) Asthma Network of West Michigan
390 Jefferson SE Ste 3
Grand Rapids,MI49503 		38-3351467 501(c)(3) 107,000       Asthma prevention
(8) Healthnet of West MI DBA Kent Health Plan
620 Century Ave SW
Grand Rapids,MI49503 		38-3609504 501(c)(3) 100,000       Obesity Management and Physical Fitness
(9) Mel Trotter Ministries
225 Commerce SW
Grand Rapids,MI49503 		38-1410467 501(c)(3) 90,000       Recouperation Center Services/Food Assistance
(10) Home Repair Services
1100 South Division
Grand Rapids,MI49507 		38-2263817 501(c)(3) 70,000       Food and Nutrition Education through Community Food Club
(11) Catherines Health Center
1211 Lafayette NE
Grand Rapids,MI49506 		20-3572418 501(c)(3) 60,000       Medical Care Services
(12) Healthy Homes Coalition
742 Franklin St SE
Grand Rapids,MI49507 		20-5326650 501(c)(3) 50,000       Asthma prevention
(13) National Kidney Foundation
1169 Oak Valley Drive NE
Ann Arbor,MI48108 		38-1559941 501(c)(3) 50,000       Obesity Management and Physical Fitness
(14) YMCA
475 Lake Michigan Dr NW
Grand Rapids,MI49503 		38-1358058 501(c)(3) 50,000       Obesity Management and Physical Fitness
(15) Family Futures
678 Front Ave NW
Grand Rapids,MI49504 		38-2605028 501(c)(3) 37,000       Early Childhood development evaluation
(16) Wellhouse
600 Cass SE
Grand Rapids,MI49503 		38-2779457 501(c)(3) 35,000       Food and Nutrition Education
(17) Literacy Center of West Michigan
1120 Monroe Ave NW
Grand Rapids,MI49503 		38-2725232 501(c)(3) 35,000       Literacy Programming
(18) LINCUP
1167 Madison Ave SE
Grand Rapids,MI49507 		38-3537915 501(c)(3) 34,500       Social Determinants of Health Management
(19) Grand Rapids African American Health Institute
515 Michigan NE
Grand Rapids,MI49503 		06-1658200 501(c)(3) 25,000       Food & Health Education
(20) Heartside Ministries
54 S Division
Grand Rapids,MI49503 		38-2477760 501(c)(3) 25,000       Medical Care Services
(21) Steepletown Neighborhood
671 Davis Ave NW
Grand Rapids,MI49504 		38-3246215 501(c)(3) 25,000       Food and Nutrition Education
(22) Baxter Center
935 Baxter SE
Grand Rapids,MI49503 		38-2779590 501(c)(3) 20,000       Underserved GED Assistance
(23) Degage Ministries
144 Division Ave S
Grand Rapids,MI49503 		38-1912094 501(c)(3) 20,000       Medical & Food Support
(24) Sandcastles Childrens Museum
PO Box 595 129 E Ludington Ave
Ludington,MI49431 		35-2340348 501(c)(3) 19,685       Create an interactive Nursery Exhibit
(25) Catholic Charities of West MI
40 Jefferson Ave SE
Grand Rapids,MI49503 		38-3014273 501(c)(3) 12,500       Medical Care Services
(26) LudingtonScottville Area Chamber of Commerce
5300 West US 10
Ludington,MI49431 		38-0775025 501(c)(6) 8,000       Title sponsorship of Ludington Lakeshore Classic
(27) Ludington Half Marathon
3917 N Lakeshore Drive
Ludington,MI49431 		27-2299211 501(c)(3) 7,000       Title Sponsorship to promote wellness
(28) Fulton Street Farmer's Market
1145 Fulton Street East
Grand Rapids,MI49503 		46-2859250 501(c)(3) 6,000       Food Assistance Program
(29) Salvation Army (DBA Kroc Center)
2500 South Division
Grand Rapids,MI49507 		38-2699000 501(c)(3) 6,000       Obesity Management and Physical Fitness
(30) Grand Rapids Youth Commonwealth (DBA Boys & Girls Club)
235 Straight Ave NW
Grand Rapids,MI49504 		38-0593958 501(c)(3) 5,000       Supplies
(31) Family Outreach Center Inc
1939 Division Ave
Grand Rapids,MI49507 		38-2272711 501(c)(3) 5,000       Behavioral Health for the underserved
(32) Community Foundation for Mason County
PO Box 10
Ludington,MI49431 		38-6114135 501(c)(3) 5,000       Pickleball court construction. Promotion of wellness
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
31
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2016

Schedule I (Form 990) 2016
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) SCHOLARSHIPS 12 12,000      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Spectrum Health only provides grants to organizations that have a mission and values that closely align with the mission and values of Spectrum Health. Spectrum Health focuses on providing grants to organizations that improve the health of the underserved in the community and/or organizations that increase access to health care. Recipients receiving grants greater than $25,000 are required to submit to Spectrum Health quarterly itemized financial reports. For grants less than $25,000 Spectrum Health documents the restriction of the funds for specific programs that support the underserved or increase access to health care. The purpose of not requesting financial reports for smaller gifts is due to the significant level of effort that it would impose upon the community organizations who often have limited resources to provide the documentation. Spectrum Health provides scholarships to local high school or college students pursuing medical careers. To be eligible for the scholarship students must provide academic transcripts and/or letter of acceptance from an accredited college. Scholarship funds are paid directly to the student's college.
Schedule I (Form 990) 2016



Additional Data


Software ID: 16000421
Software Version: 2016v3.0