GUILFORD ADULT HEALTH INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
GUILFORD ADULT HEALTH INC (EIN 04-3726317)
Tax period
2021-10-01 to 2022-09-30
Filed
2023-01-25
IRS object ID
202310259349300041
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-01-25T11:49:04-06:00ReturnTs
Tax Period End2022-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560817345PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1TURLINGTON AND COMPANY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11338 WESTGATE CENTER DRIVEAddressLine1Txt
CityWINSTONSALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043726317EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GUILFORD ADULT HEALTH INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGUILBusinessNameControlTxt
Phone3365559700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4031AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27404ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLISA DUCKPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3365559700PhoneNum
Signature2023-01-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLISAPersonFirstNm
Person LastDUCKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDEXTER A GARNERPreparerPersonNm
PTINP01276494PTIN
Phone3367652410PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-03-07 01:45:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLISA DUCKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4031AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27404ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$761,912GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GUILFORDCCN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE ACCESSIBLE, AFFORDABLE, AND QUALITY MEDICAL AND DENTAL SERVICES TO GUILFORD COUNTY RESIDENTS WITH INCOMES BETWEEN 0% AND 200% OF THE FEDERAL POVERTY LEVEL.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,201,260PYContributionsGrantsAmt
CY Contributions Grants$725,742CYContributionsGrantsAmt
PY Program Service Revenue$18,480PYProgramServiceRevenueAmt
CY Program Service Revenue$33,512CYProgramServiceRevenueAmt
PY Investment Income$1,783PYInvestmentIncomeAmt
CY Investment Income$2,658CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,221,523PYTotalRevenueAmt
CY Total Revenue$761,912CYTotalRevenueAmt
PY Grants And Similar Paid$399,856PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$401,703CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$513,261PYOtherExpensesAmt
CY Other Expenses$494,517CYOtherExpensesAmt
PY Total Expenses$913,117PYTotalExpensesAmt
CY Total Expenses$896,220CYTotalExpensesAmt
PY Revenues Less Expenses$308,406PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$134,308CYRevenuesLessExpensesAmt
Total Assets BOY$1,767,216TotalAssetsBOYAmt
Total Assets EOY$1,638,546TotalAssetsEOYAmt
Total Liabilities BOY$53,176TotalLiabilitiesBOYAmt
Total Liabilities EOY$58,814TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,714,040NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,579,732NetAssetsOrFundBalancesEOYAmt
MissionTO ENSURE THAT ALL PERSONS HAVE ACCESS TO QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTHCARE THROUGH INNOVATIVE COMMUNITY PARTNERSHIPS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$838,508ExpenseAmt
Grant$401,703GrantAmt
Revenue$33,512RevenueAmt
DescGUILFORD ADULT HEALTH PROVIDED DENTAL SERVICES TO PATIENTS BELOW THE POVERTY LEVEL, CREATED AND ADMINISTERED AN INFORMATION SHARING NETWORK FOR AN ELIGIBILITY PROCESS FOR INDIGENT PATIENTS, AND FUNDED OTHER ORGANIZATIONS PROVIDING PRIMARY MEDICAL CARE SERVICES.Desc
Total Program Service Expenses$838,508TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DESHANDRA WOODLEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3363559696PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 4031AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27404ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
PATRICIA A SOENKSEN
CHAIRPERSON2.00Yes (X)Yes (X)$0$0$0
MICHELLE LEWIS
VICE-CHAIR2.00Yes (X)Yes (X)$0$0$0
CHESTER BROWN III
TREASURER2.00Yes (X)Yes (X)$0$0$0
KAREN GAMMONS
SECRETARY2.00Yes (X)Yes (X)$0$0$0
IULIA VANN
BOARD MEMBER1.00Yes (X)$0$0$0
LAURA MURRAY
BOARD MEMBER1.00Yes (X)$0$0$0
AASHKA MEHTA
BOARD MEMBER1.00Yes (X)$0$0$0
MICHAEL HALFORD
BOARD MEMBER1.00Yes (X)$0$0$0
BRIAN SEELY
BOARD MEMBER1.00Yes (X)$0$0$0
LISA DUCK
EXECUTIVE DIRECTOR40.00Yes (X)$0$130,869$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$130,869TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$20,000FederatedCampaignsAmt
All Other Contributions$705,742AllOtherContributionsAmt
Noncash Contributions$3,100NoncashContributionsAmt
Total Contributions$725,742TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSERVICE REVENUEDesc
Business624100BusinessCd
Total Revenue Column$33,512TotalRevenueColumnAmt
Related Or Exempt Func Income$33,512RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$33,512TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,658TotalRevenueColumnAmt
Exclusion$2,658ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$761,912TotalRevenueColumnAmt
Related Or Exempt Func Income$33,512RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,658ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$401,703TotalAmt
Program Services$401,703ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$85,255TotalAmt
Program Services$78,685ProgramServicesAmt
Management And General$6,570ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$296,247TotalAmt
Program Services$253,195ProgramServicesAmt
Management And General$43,052ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,346TotalAmt
Program Services$3,346ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$15,093TotalAmt
Program Services$14,338ProgramServicesAmt
Management And General$755ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,400TotalAmt
Program Services$2,400ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$23,254TotalAmt
Program Services$23,254ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,345TotalAmt
Program Services$3,345ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,097TotalAmt
Program Services$4,097ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,876TotalAmt
Program Services$5,845ProgramServicesAmt
Management And General$1,031ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$13,962$13,962
PATIENT CARE$13,824$13,824
TELEPHONE$11,407$9,840$1,567
DUES AND SUBSCRIPTIONS$10,130$6,083$4,047

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,281TotalAmt
Program Services$4,591ProgramServicesAmt
Management And General$690ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$896,220TotalAmt
Program Services$838,508ProgramServicesAmt
Management And General$57,712ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,490,664BOYAmt
EOY$1,596,975EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$254,740BOYAmt
EOY$24,883EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,694BOYAmt
EOY$667EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$84,752LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$68,731LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$20,118BOYAmt
EOY$16,021EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,767,216BOYAmt
EOY$1,638,546EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$53,176BOYAmt
EOY$58,814EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$53,176BOYAmt
EOY$58,814EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$926,799BOYAmt
EOY$996,311EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$787,241BOYAmt
EOY$583,421EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,714,040BOYAmt
EOY$1,579,732EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,767,216BOYAmt
EOY$1,638,546EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$134,308ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$940,346CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$869,306CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$828,894CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,201,260CurrentTaxYearMinus1YearAmt
Current Tax Year$725,742CurrentTaxYearAmt
Total$4,565,548TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$940,346CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$869,306CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$828,894CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,201,260CurrentTaxYearMinus1YearAmt
Current Tax Year$725,742CurrentTaxYearAmt
Total$4,565,548TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$112,307SubstantialContributorsTotAmt
Public Support Total170$4,453,241PublicSupportTotal170Amt
Total Support$4,565,548TotalSupportAmt
Public Support CY1700.97540PublicSupportCY170Pct
Public Support PY1700.84290PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,752OtherCostOrOtherBasisAmt
Depreciation$68,731DepreciationAmt
Book Value$16,021BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,021TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$761,912TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$761,912RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$761,912TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$896,220TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$896,220ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$896,220TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HAS DETERMINED THAT IT HAS NO UNCERTAIN INCOME TAX POSITIONS AS OF SEPTEMBER 30, 2022. ALSO, THE ORGANIZATION DOES NOT ANTICIPATE ANY INCREASE OR DECREASE IN UNRECOGNIZED TAX BENEFITS DURING THE NEXT TWELVE MONTHS THAT WOULD RESULT IN A MATERIAL CHANGE TO ITS FINANCIAL POSITION.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CONE HEALTH SYSTEMBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 N ELM STREETAddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27401ZIPCd
FieldValueIRS element (for citing)
Recipient EIN581588823RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$401,703CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantPAYMENT OF WAGES & BENEFITSPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MOSES H. CONE MEMORIAL HOSPITAL ("MOSES CONE") AND HIGH POINT REGIONAL HEALTH ("HIGH POINT") RECEIVE ASSETS UPON DISSOLUTION.
FORM 990, PART VI, SECTION A, LINE 7ATHE MOSES H. CONE MEMORIAL HOSPITAL ("MOSES CONE") AND HIGH POINT REGIONAL HEALTH ("HIGH POINT") RECEIVE ASSETS UPON DISSOLUTION.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE 990 WAS MADE AVAILABLE TO THE BOARD ALONG WITH THE FINANCIAL STATEMENTS FOR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED ANNUALLY BY EACH BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE DIRECTOR DEVELOPS PERFORMANCE GOALS EACH FISCAL YEAR WHICH ARE APPROVED BY THE BOARD. THE BOARD REVIEWS THE ACTUAL PERFORMANCE OF THE EXECUTIVE DIRECTOR AND COMPARES TO GOAL INITIALLY ESTABLISHED ON AN ANNUAL BASIS IN AN EFFORT TO DETERMINE HER COMPENSATION. BOARD MEMBERS ARE FROM VARIOUS ORGANIZATIONS IN THE NONPROFIT, BUSINESS, AND MEDICAL AND HUMAN SERVICES INDUSTRIES. THEY USE LABOR MARKET BASED COMPARISONS FROM THEIR RESPECTIVE ORGANIZATIONS TO DETERMINE THE EXECUTIVE DIRECTOR'S COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 18THE 990 IS MADE AVAILABLE ON PUBLIC WEBSITES, SUCH AS GUIDESTAR. IT IS ALSO AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS ARE ON FILE WITH THE EXECUTIVE DIRECTOR. INFORMATION IS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GGRANT WRITING AND OTHER: PROGRAM SERVICE EXPENSES 38,489. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,489. STIPEND: PROGRAM SERVICE EXPENSES 20,100. MANAGEMENT AND GENERAL EXPENSES 3,376. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,476. CONSULTING: PROGRAM SERVICE EXPENSES 40,672. MANAGEMENT AND GENERAL EXPENSES 39,676. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,348. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 153,934. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 153,934.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
THE MOSES H CONE MEMORIAL HOSPITAL
1200 N ELM STREETGREENSBORONC27401581588823HOSPITALNC501(C)(3)170(B)(1)(A)N/A0
HIGH POINT REGIONAL HEALTH
601 N ELM STREETHIGH POINTNC27261560532309HOSPITALNC501(C)(3)170(B)(1)(A)N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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