Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) 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
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) DARRYL ELMOUCHI
  		OFFICER, SHMG TUITION ASSISTANCE   X 84,600 54,830   No   No Yes  
(2) DAVID OTTENBAKER MD
  		DIRECTOR, SHP/SHZ TUITION ASSISTANCE   X 36,000 7,846   No   No Yes  
(3) JASON SLAIKEU
  		OFFICER, SHMG TUITION ASSISTANCE   X 27,000 18,587   No   No Yes  
(4) LESLIE JURECKO
  		DIRECTOR, SHMG TUITION ASSISTANCE   X 27,000 27,557   No   No Yes  
(5) BRETT ZIMMERMAN
  		DIRECTOR, SHMG TUITION ASSISTANCE   X 27,000 27,557   No   No Yes  
(6) SIMIN BEG
  		DIRECTOR, SHMG TUITION ASSISTANCE   X 27,000 18,587   No   No Yes  
(7) RYAN JOHNSON
  		OFFICER, SHU/SHK TUITION ASSISTANCE   X 13,500 14,192   No   No Yes  
(8) KEVIN NICHOLS
  		OFFICER, SHGM/SHP - PART YEAR TUITION ASSISTANCE   X 13,500 14,192   No   No Yes  
(9) GREG GADBOIS
  		OFFICER, SHMG - PART YEAR TUITION ASSISTANCE   X 13,500 14,192   No   No Yes  
Total ...............Small Bullet $ 197,540
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2016
Schedule L (Form 990 or 990-EZ) 2016
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) STEPHEN RECHNER
  		FAMILY 635,172 SHMG-SEE SCH L, PART V   No
(2) MARKA STEENSMA
  		FAMILY 322,502 SHMG-SEE SCH L, PART V   No
(3) AMWAY HOTEL CORPORATION
  		BUSINESS 258,785 SHF-SEE SCH L, PART V   No
(4) TIMOTHY O'CALLAGHAN
  		FAMILY 236,031 SHMG-SEE SCH L, PART V   No
(5) MARLENE HOLSTINE
  		FAMILY 133,888 SHZ-SEE SCH L, PART V   No
(6) SUSAN PHILLIPS
  		FAMILY 133,884 SHMG-SEE SCH L, PART V   No
(7) SHIRLEY TULLER
  		FAMILY 84,850 SHL-See Sch L, Part V   No
(8) MICHELLE PETZ
  		FAMILY 66,588 SHGM-SEE SCH L, PART V   No
(9) MARGARET MAHAR
  		FAMILY 51,288 SHU-SEE SCH L, PART V   No
(10) JENNIFER VIPPERMAN
  		FAMILY 48,495 SHL-SEE SCH L, PART V   No
(11) KELLY JOHNSON
  		FAMILY 39,073 SHU-SEE SCH L, PART V   No
(12) TARA ANAMA
  		FAMILY 34,374 SHZ-SEE SCH L, PART V   No
(13) THOMAS KNOERL II
  		FAMILY 24,207 SHRC-SEE SCH L, PART V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part V SHZ FAMILY RELATIONSHIPS WITH INTERESTED PERSONS MR. STAN KONYNENBELT, A MEMBER OF SHZ'S BOARD OF DIRECTORS, HAS A SIBLING THAT IS EMPLOYED BY SHZ. (PART IV, LINE 5) MR. KURT WASSINK, A MEMBER OF SHZ'S BOARD OF DIRECTORS, HAS A SISTER-IN-LAW THAT IS EMPLOYED BY SHZ. (PART IV, LINE 12).
Schedule L, Part V SHU FAMILY RELATIONSHIPS WITH INTERESTED PERSONS MR. RYAN JOHNSON, AN OFFICER OF SHU, HAS A SPOUSE THAT IS EMPLOYED BY SHU. (PART IV, LINE 11) MS. PRISCILLA MAHAR, AN OFFICER OF SHU, HAS A SISTER-IN-LAW THAT IS EMPLOYED BY SHU. (PART IV, LINE 9)
Schedule L, Part V SHGM FAMILY RELATIONSHIPS WITH INTERESTED PERSONS MR. WILLIAM LEAVER, A MEMBER OF SHGM'S BOARD OF DIRECTORS, HAS A SISTER-IN-LAW THAT IS EMPLOYED BY SHGM. (PART IV, LINE 8)
Schedule L, Part V SHF BUSINESS RELATIONSHIPS WITH INTERESTED PERSONS MS. MARIA DEVOS, A MEMBER OF SHF'S BOARD OF DIRECTORS, HAS AN INDIRECT OWNERSHIP INTEREST IN A TAXABLE ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH SHF. (PART IV, LINE 3)
Schedule L, Part V SHMG FAMILY RELATIONSHIPS WITH INTERESTED PERSONS MS. MARY O'CALLAGHAN, A MEMBER OF THE SHMG BOARD OF DIRECTORS, HAS A SPOUSE THAT IS EMPLOYED BY SHMG. (PART IV, LINE 4) MR. BRIAN PHILLIPS, AN OFFICER AND MEMBER OF THE SHMG BOARD OF DIRECTORS, HAS A SPOUSE THAT IS EMPLOYED BY SHMG. (PART IV, LINE 6) MS. MELINDA JOHNSON, A MEMBER OF THE SHMG BOARD OF DIRECTORS, HAS A FATHER-IN-LAW THAT IS EMPLOYED BY SHMG. (PART IV, LINE 1) MR. MATTHEW STEENSMA, A MEMBER OF THE SHMG BOARD OF DIRECTORS, HAS A SPOUSE THAT IS EMPLOYED BY SHMG. (PART IV, LINE 2)
Schedule L, Part V SHL BUSINESS AND FAMILY RELATIONSHIPS WITH INTERESTED PERSONS MS. LINDA CRONENWETT, A MEMBER OF SHL'S BOARD OF DIRECTORS, HAS A SPOUSE THAT IS EMPLOYED BY SHL. (PART IV, LINE 7) MR. MARK VIPPERMAN, A FORMER OFFICER OF SHL, HAS A DAUGHTER THAT IS EMPLOYED BY SHL. (PART IV, LINE 10)
Schedule L, Part V SHRC FAMILY RELATIONSHIPS WITH INTERESTED PERSONS MR. THOMAS KNOERL, AN OFFICER OF SHRC, HAS A SON THAT IS EMPLOYED BY SHRC. (PART IV, LINE 13)
Schedule L (Form 990 or 990-EZ) 2016


Additional Data


Software ID: 16000421
Software Version: 2016v3.0