GREENE COUNTY HEALTH INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: GREENE COUNTY HEALTH INC (EIN 47-4673365)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-05-02
IRS object ID: 202241229349301674
Schema version: 2020v4.0
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
Form 990
Schedule A
Schedule D
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-05-02T11:56:03-07:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	351719602	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Bradley & Associates Inc	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	201 S Capitol Ave Ste 700	AddressLine1Txt
City	Indianapolis	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46225	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	474673365	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Greene County Health Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GREE	BusinessNameControlTxt
Phone	8126694153	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1600 A St NE Suite 9	AddressLine1Txt
City	Linton	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47441	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Crystal Plano	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2022-05-02	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Crystal	PersonFirstNm
Person Last	Plano	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	SKANDER NASSER III	PreparerPersonNm
PTIN	P00236505	PTIN
Phone	3172375500	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd
Federated Assurance Level	FAL1	FederatedAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Crystal Plano	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1600 A St NE Suite 9	AddressLine1Txt
City	Linton	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47441	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$3,408,525	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.gc-health.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2015	FormationYr
Legal Domicile State	IN	LegalDomicileStateCd
Activity Or Mission	The organization provides medical services to area residents. With two locations in Greene County, Indiana, the physicians, advance practice providers and other healthcare professionals provide family practice care for the area's residents.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	31	TotalEmployeeCnt
Total Volunteers	10	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$397,258	PYContributionsGrantsAmt
CY Contributions Grants	$413,343	CYContributionsGrantsAmt
PY Program Service Revenue	$2,628,077	PYProgramServiceRevenueAmt
CY Program Service Revenue	$2,426,006	CYProgramServiceRevenueAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$306,085	PYOtherRevenueAmt
CY Other Revenue	$569,176	CYOtherRevenueAmt
PY Total Revenue	$3,331,420	PYTotalRevenueAmt
CY Total Revenue	$3,408,525	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,549,977	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,566,904	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,375,475	PYOtherExpensesAmt
CY Other Expenses	$1,468,473	CYOtherExpensesAmt
PY Total Expenses	$2,925,452	PYTotalExpensesAmt
CY Total Expenses	$3,035,377	CYTotalExpensesAmt
PY Revenues Less Expenses	$405,968	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$373,148	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,169,351	TotalAssetsBOYAmt
Total Assets EOY	$1,224,880	TotalAssetsEOYAmt
Total Liabilities BOY	$6,141,872	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,020,708	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$4,972,521	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$4,795,828	NetAssetsOrFundBalancesEOYAmt
Mission	The organization provides medical services to area residents. With two locations in Greene County, Indiana, the physicians, advance practice providers and other healthcare professionals provide family practice care for the area's residents.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$2,490,698	ExpenseAmt
Revenue	$2,426,006	RevenueAmt
Desc	The organization provides medical services to area residents. With two locations in Greene County, Indiana, the physicians, advance practice providers and other healthcare professionals provide family practice care for the area's residents.	Desc
Total Program Service Expenses	$2,490,698	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	4	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	31	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Form8282 Filed	0	Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	false	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Crystal Plano	PersonNm
Phone	8126694153	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1600 A St NE Suite 9	AddressLine1Txt
City	Linton	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	47441	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Derek Parkes
Physician	40.00	0.00	$203,471	$0	$11,125
Corianne Vanderkolk
CEO	40.00	0.00	$139,146	$0	$6,812	Yes (X)
Crystal Plano
CFO	40.00	0.00	$92,816	$0	$4,085	Yes (X)
Linda Bedwell
Vice Chairman	2.00	0.00	$0	$0	$0		Yes (X)
Paul Quiel
Director	2.00	0.00	$0	$0	$0		Yes (X)
Susie Leigh
Director	2.00	0.00	$0	$0	$0		Yes (X)
Sue Ann Johnson
Secretary	2.00	0.00	$0	$0	$0		Yes (X)
Margaret Simon
Vice Chairman	2.00	0.00	$0	$0	$0		Yes (X)
Mary Lou Quiel
Chairman	2.00	0.00	$0	$0	$0		Yes (X)
Christa Turpin
Director	2.00	0.00	$0	$0	$0		Yes (X)
Susie Slinkard
Director	2.00	0.00	$0	$0	$0		Yes (X)
Lianne Wilson
Treasurer	2.00	0.00	$0	$0	$0		Yes (X)
Joe Wise
Treasurer	2.00	0.00	$0	$0	$0		Yes (X)
Mike Schantz
Director	2.00	0.00	$0	$0	$0		Yes (X)
Janet Rose
Director	2.00	0.00	$0	$0	$0		Yes (X)
Sherry Vandeventer
Director	2.00	0.00	$0	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$435,433	TotalReportableCompFromOrgAmt
Total Other Compensation	$22,022	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Government Grants	$413,307	GovernmentGrantsAmt
All Other Contributions	$36	AllOtherContributionsAmt
Total Contributions	$413,343	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Patient Service Revenue	Desc
Business	621110	BusinessCd
Total Revenue Column	$2,426,006	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,426,006	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$2,426,006	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340B Revenue	900099	$550,078	$550,078
Medical Records	900099	$2,830	$2,830
Miscellaneous Income	900099	$16,268	$16,268

Field	Value	IRS element (for citing)
Other Revenue Total	$569,176	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,408,525	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,995,182	RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$240,367	TotalAmt
Program Services	$180,275	ProgramServicesAmt
Management And General	$60,092	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$994,733	TotalAmt
Program Services	$746,050	ProgramServicesAmt
Management And General	$248,683	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$209,390	TotalAmt
Program Services	$157,043	ProgramServicesAmt
Management And General	$52,347	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$122,414	TotalAmt
Program Services	$91,810	ProgramServicesAmt
Management And General	$30,604	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$688	TotalAmt
Management And General	$688	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$61,243	TotalAmt
Management And General	$61,243	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$223,528	TotalAmt
Program Services	$212,352	ProgramServicesAmt
Management And General	$11,176	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$4,954	TotalAmt
Management And General	$4,954	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$54,850	TotalAmt
Program Services	$41,138	ProgramServicesAmt
Management And General	$13,712	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$133,920	TotalAmt
Program Services	$133,920	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,849	TotalAmt
Program Services	$924	ProgramServicesAmt
Management And General	$925	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$3,269	TotalAmt
Program Services	$1,635	ProgramServicesAmt
Management And General	$1,634	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$9,366	TotalAmt
Management And General	$9,366	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$48,787	TotalAmt
Management And General	$48,787	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
Contractual Expense	$725,842	$725,842
Vaccination Expense	$82,410	$82,410
340B Expense	$80,670	$80,670
Medical Supplies	$35,225	$35,225

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,872	TotalAmt
Program Services	$1,404	ProgramServicesAmt
Management And General	$468	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,035,377	TotalAmt
Program Services	$2,490,698	ProgramServicesAmt
Management And General	$544,679	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$859,294	BOYAmt
EOY	$1,029,401	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$213,117	BOYAmt
EOY	$92,549	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$22,888	BOYAmt
EOY	$28,395	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$96,308	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$21,773	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$74,052	BOYAmt
EOY	$74,535	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,169,351	BOYAmt
EOY	$1,224,880	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,344,149	BOYAmt
EOY	$1,234,990	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$4,797,723	BOYAmt
EOY	$4,785,718	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,141,872	BOYAmt
EOY	$6,020,708	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$4,973,771	BOYAmt
EOY	-$4,795,828	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,250	BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$4,972,521	BOYAmt
EOY	-$4,795,828	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,169,351	BOYAmt
EOY	$1,224,880	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$373,148	ReconcilationRevenueExpnssAmt
Prior Period Adjustments	-$196,455	PriorPeriodAdjustmentsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$59,850	OtherCostOrOtherBasisAmt
Depreciation	$12,693	DepreciationAmt
Book Value	$47,157	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$36,458	OtherCostOrOtherBasisAmt
Depreciation	$9,080	DepreciationAmt
Book Value	$27,378	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$74,535	TotalBookValueLandBuildingsAmt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Independent Consultant	Yes (X)	IndependentConsultantInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	Derek Parkes	PersonNm
Title	Physician	TitleTxt
Base Compensation Filing Org	$200,571	BaseCompensationFilingOrgAmt
Bonus Filing Organization	$2,900	BonusFilingOrganizationAmount
Deferred Compensation Flng Org	$10,081	DeferredCompensationFlngOrgAmt
Nontaxable Benefits Filing Org	$1,044	NontaxableBenefitsFilingOrgAmt
Total Compensation Filing Org	$214,596	TotalCompensationFilingOrgAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et	The Board Chair (Mary Lou Quiel) and a Director of the Board (Paul Quiel) are married.
Form 990, Part VI, Line 11b: Form 990 Review Process	The Form 990 will be provided to the Board for review and to solicit their input. The Form 990 will not be filed until all feedback is received and the appropriate changes, if any, are made. The Form 990 is also reviewed by an independent accounting firm prior to filing.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Each employee and Board Member is required to complete a new conflict of interest form annually. These are reviewed by the compliance office who continues to monitor for compliance issues.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	The Agency has an agreement with Sullivan County Hospital for their HR services. The Agency works with their HR personnel to review market compensation for all employees, including key employees. The Agency uses the data obtained from Sullivan County Hospital HR to determine compensation.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request only and with Board approval.