NORTH COUNTRY FAMILY HEALTH CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NORTH COUNTRY FAMILY HEALTH CENTER INC (EIN 16-1030802)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-08
- IRS object ID
- 202213129349302161
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-08T09:59:31-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 432 NORTH FRANKLIN STREET | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161030802 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH COUNTRY FAMILY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 3157829450 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 238 ARSENAL STREET | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOEY MARIE HORTON | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 3157829450 | PhoneNum |
| Signature | 2022-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOEY | PersonFirstNm |
| Person Last | MARIE HORTON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BETTINA LIPPHARDT | PreparerPersonNm |
| PTIN | P00956232 | PTIN |
| Phone | 3154227109 | PhoneNum |
| Preparation | 2022-11-08 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOEY MARIE HORTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 238 ARSENAL STREET | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,001,592 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.NOCOFAMILYHEALTH.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO OPEN THE DOORS TO BETTER HEALTHCARE. WE BELIEVE THAT EVERY INDIVIDUAL IN OUR COMMUNITY DESERVES HIGH-QUALITY, AFFORDABLE HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 187 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,136,683 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,486,254 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,853,920 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,412,731 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,211 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,136 | CYInvestmentIncomeAmt |
| PY Other Revenue | $36,436 | PYOtherRevenueAmt |
| CY Other Revenue | $98,455 | CYOtherRevenueAmt |
| PY Total Revenue | $11,034,250 | PYTotalRevenueAmt |
| CY Total Revenue | $12,998,576 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,815,904 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,990,758 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $4,290 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,093,794 | PYOtherExpensesAmt |
| CY Other Expenses | $3,447,662 | CYOtherExpensesAmt |
| PY Total Expenses | $10,909,698 | PYTotalExpensesAmt |
| CY Total Expenses | $12,438,420 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $124,552 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $560,156 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,928,996 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,695,975 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,581,273 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,788,096 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,347,723 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,907,879 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH, WELLNESS, AND QUALITY OF LIFE OF ALL INDIVIDUALS IN OUR COMMUNITY BY PROVIDING ACCESSIBLE, HIGH QUALITY, AFFORDABLE, PATIENT-CENTERED AND INTEGRATED HEALTH SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,250,283 | ExpenseAmt |
| Revenue | $6,473,694 | RevenueAmt |
| Desc | HEALTH SERVICES - THE HEALTH CENTER PROVIDES OUTPATIENT AND INPATIENT MEDICAL CARE, DENTAL CARE, AND BEHAVIORAL HEALTH SERVICES TO CHILDREN AND ADULTS. SERVICES INCLUDE PHYSICAL AND DENTAL EXAMS, DIAGNOSIS AND TREATMENT, NEWBORN CARE, PARENTING AND HEALTH EDUCATION FOR ALL AGES, IMMUNIZATIONS, DEVELOPMENTAL SCREENINGS, PSYCHOLOGICAL AND COUNSELING SERVICES, AND REFERRALS TO SPECIALISTS AND FOLLOW-UP AGENCIES. 46,228 VISITS IN 2021. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $918,969 | ExpenseAmt |
| Desc | NUTRITION - THE HEALTH CENTER OPERATES THE WIC PROGRAM THAT PROVIDES NUTRIENT-RICH FOODS, NUTRITION EDUCATION, AND HEALTHY RESOURCES TO "AT RISK" PREGNANT WOMEN, NEW MOTHERS, INFANTS, AND CHILDREN UP TO AGE FIVE. AS A FEDERALLY QUALIFIED HEALTH CENTER, THE AGENCY EMPLOYS A REGISTERED DIETICIAN WHO PROVIDES NUTRITION EDUCATION AND COUNSELING TO PATIENTS WITH CHRONIC ILLNESS. 21,433 VISITS IN 2021. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,169,252 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 187 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIN HUNTER | PersonNm |
| Phone | 3157829450 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 238 ARSENAL STREET | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BRENDAN DIRRANE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHER VANBROCKLIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTIAN TAYLOR | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDSAY BALDWIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOANNA LOOMIS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MAXINE BRIGGS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SARAH MILETTA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EILEEN SNYDER | ||||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LYNNE FERRIS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK GAINES | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JORDAN JONES | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LESLIE DISTEFANO | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JESSE ROSHIA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES REDMORE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOEY MARIE HORTON | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $127,405 | $0 | $17,829 | Yes (X) | |||
| ERIN HUNTER | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $95,247 | $0 | $3,023 | Yes (X) | |||
| MARIA DILLE | ||||||||
| DENTIST | 40.00 | $175,150 | $0 | $11,121 | 1.00 | Yes (X) | ||
| MANOJ JAIN | ||||||||
| DENTIST | 40.00 | $185,621 | $0 | $15,720 | 1.00 | Yes (X) | ||
| BETH ANN JAYNE | ||||||||
| PHYSICIAN | 40.00 | $269,421 | $0 | $5,729 | 1.00 | Yes (X) | ||
| DIANE JONES | ||||||||
| PEDIATRICIAN | 40.00 | $282,481 | $0 | $3,284 | 1.00 | Yes (X) | ||
| SCOTT STERN | ||||||||
| PHYSICIAN | 40.00 | $277,763 | $0 | $16,487 | 1.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,413,088 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $73,193 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NORTHERN TIER CONSTRUCTION INC | |||||
| 329A SCOTCH SETTLEMENT ROAD | GOUVERNEUR | NY | 13642 | CONSTRUCTION | $205,334 |
| ABW MEDICAL LLC | |||||
| 237 A STREET | SAN DIEGO | CA | 92101 | MEDICAL BILLING | $169,000 |
| ENI MECHANICAL INC | |||||
| 39 S GORDON STREET | GOUVERNEUR | NY | 13642 | HVAC SYSTEM SERVICES | $164,689 |
| VISUALUTIONS | |||||
| 7440 MINTWOOD LANE | SPRING | TX | 77379 | HOSTING SERVICES & IT SUPPORT | $145,428 |
| COMPREHENSIVE MEDICINE PLLC | |||||
| 105 DUFFIELD ROAD | ROCHESTER | NY | 14618 | BEHAVIORAL HEALTH TELEMEDICINE | $122,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,350,718 | GovernmentGrantsAmt |
| All Other Contributions | $135,536 | AllOtherContributionsAmt |
| Total Contributions | $6,486,254 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID AND MEDICARE | 624100 | $3,832,281 | $3,832,281 |
| THIRD PARTY PAYORS AND SELF-PAY | 621300 | $1,736,268 | $1,736,268 |
| INCENTIVE INCOME | 621990 | $328,537 | $328,537 |
| 340B INCOME | 621990 | $282,121 | $282,121 |
| SAFETY NET REVENUE | 621990 | $233,524 | $233,524 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,412,731 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,136 | TotalRevenueColumnAmt |
| Exclusion | $1,136 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $40,508 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $3,016 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,492 | TotalRevenueColumnAmt |
| Exclusion | $37,492 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 999999 | BusinessCd |
| Total Revenue Column | $60,963 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,963 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $60,963 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,998,576 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,473,694 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,628 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,506 | TotalAmt |
| Management And General | $243,506 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,491,267 | TotalAmt |
| Program Services | $6,296,891 | ProgramServicesAmt |
| Management And General | $1,194,376 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,941 | TotalAmt |
| Program Services | $104,387 | ProgramServicesAmt |
| Management And General | $14,554 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,317 | TotalAmt |
| Program Services | $423,430 | ProgramServicesAmt |
| Management And General | $83,887 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,727 | TotalAmt |
| Program Services | $520,736 | ProgramServicesAmt |
| Management And General | $108,991 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,173 | TotalAmt |
| Management And General | $8,173 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,592 | TotalAmt |
| Program Services | $186,932 | ProgramServicesAmt |
| Management And General | $74,660 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,719 | TotalAmt |
| Program Services | $337,216 | ProgramServicesAmt |
| Management And General | $79,503 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,468 | TotalAmt |
| Program Services | $22,029 | ProgramServicesAmt |
| Management And General | $41,439 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $675,792 | TotalAmt |
| Program Services | $496,265 | ProgramServicesAmt |
| Management And General | $177,560 | ManagementAndGeneralAmt |
| Fundraising | $1,967 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,577 | TotalAmt |
| Program Services | $97,854 | ProgramServicesAmt |
| Management And General | $20,723 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,400 | TotalAmt |
| Program Services | $252,967 | ProgramServicesAmt |
| Management And General | $8,433 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,567 | TotalAmt |
| Program Services | $24,318 | ProgramServicesAmt |
| Management And General | $74,809 | ManagementAndGeneralAmt |
| Fundraising | $440 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,868 | TotalAmt |
| Program Services | $9,179 | ProgramServicesAmt |
| Management And General | $23,305 | ManagementAndGeneralAmt |
| Fundraising | $1,384 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,383 | TotalAmt |
| Program Services | $13,283 | ProgramServicesAmt |
| Management And General | $6,100 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $446,627 | TotalAmt |
| Program Services | $401,490 | ProgramServicesAmt |
| Management And General | $45,137 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,752 | TotalAmt |
| Program Services | $41,158 | ProgramServicesAmt |
| Management And General | $4,594 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PROGRAM SUPPLIES | $613,039 | $611,156 | $1,883 | |
| REPAIRS AND MAINTENANCE | $210,354 | $161,801 | $48,553 | |
| PROVISION FOR DOUBTFUL | $141,325 | $141,325 | ||
| MISCELLANEOUS | $32,026 | $26,835 | $4,692 | $499 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,438,420 | TotalAmt |
| Program Services | $10,169,252 | ProgramServicesAmt |
| Management And General | $2,264,878 | ManagementAndGeneralAmt |
| Fundraising | $4,290 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,724,250 | BOYAmt |
| EOY | $4,656,397 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,001 | BOYAmt |
| EOY | $964,089 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $552,618 | BOYAmt |
| EOY | $1,159,678 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,665 | BOYAmt |
| EOY | $155,735 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,234,090 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,474,014 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,530,462 | BOYAmt |
| EOY | $3,760,076 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,928,996 | BOYAmt |
| EOY | $10,695,975 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,260,628 | BOYAmt |
| EOY | $1,493,261 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,789 | BOYAmt |
| EOY | $323,856 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600,350 | BOYAmt |
| EOY | $478,098 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,542,044 | BOYAmt |
| EOY | $1,492,881 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,462 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,581,273 | BOYAmt |
| EOY | $3,788,096 | 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 | $6,347,723 | BOYAmt |
| EOY | $6,907,879 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,347,723 | BOYAmt |
| EOY | $6,907,879 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,928,996 | BOYAmt |
| EOY | $10,695,975 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $560,156 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,418,715 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,867,595 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,586,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,136,683 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,526,762 | CurrentTaxYearAmt |
| Total | $25,536,644 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,722,534 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,086,355 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,952,083 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,890,356 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,473,694 | CurrentTaxYearAmt |
| Total | $28,125,022 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,141,249 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,953,950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,538,972 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,027,039 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,000,456 | CurrentTaxYearAmt |
| Total | $53,661,666 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $53,661,666 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $966 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,993 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $41,459 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,211 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,136 | CurrentTaxYearAmt |
| Total | $61,765 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $966 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,993 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $41,459 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,211 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,136 | CurrentTaxYearAmt |
| Total | $61,765 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $30,563 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $44,915 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,417 | CurrentTaxYearMinus2YearsAmt |
| Total | $122,895 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,172,778 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,009,858 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,627,848 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,034,250 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,001,592 | CurrentTaxYearAmt |
| Total | $53,846,326 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99660 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99590 | PublicSupportPY509Pct |
| Investment Income CY | 0.00110 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00120 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,000 | OtherCostOrOtherBasisAmt |
| Book Value | $40,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,251,884 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,716,299 | DepreciationAmt |
| Book Value | $2,535,585 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $701,589 | OtherCostOrOtherBasisAmt |
| Depreciation | $183,593 | DepreciationAmt |
| Book Value | $517,996 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,125,664 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,574,122 | DepreciationAmt |
| Book Value | $551,542 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,953 | OtherCostOrOtherBasisAmt |
| Book Value | $114,953 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,760,076 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $15,570,234 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $2,568,642 | OtherRevenueAmt |
| Revenue Not Reported | $2,568,642 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,001,592 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$3,016 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$3,016 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,998,576 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,010,078 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,568,642 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,568,642 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,441,436 | ExpensesSubtotalAmt |
| Other Expenses Not Included | -$3,016 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$3,016 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,438,420 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | WIC FOOD VOUCHERS REDEEMED 2,568,642. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSE -3,016. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | WIC FOOD VOUCHERS REDEEMED 2,568,642. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSE -3,016. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | A NIGHT AT THE RIVER | Event1Nm |
| Gross Receipts Event1 | $40,508 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $40,508 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $3,016 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $40,508 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $40,508 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,016 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $3,016 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $37,492 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT STERN | ||||||||||||||
| PHYSICIAN | $277,763 | $0 | $0 | $0 | $0 | $0 | $2,864 | $0 | $13,623 | $0 | $294,250 | $0 | $0 | $0 |
| DIANE JONES | ||||||||||||||
| PEDIATRICIAN | $282,481 | $0 | $0 | $0 | $0 | $0 | $3,230 | $0 | $54 | $0 | $285,765 | $0 | $0 | $0 |
| BETH ANN JAYNE | ||||||||||||||
| PHYSICIAN | $269,421 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,729 | $0 | $275,150 | $0 | $0 | $0 |
| MANOJ JAIN | ||||||||||||||
| DENTIST | $185,621 | $0 | $0 | $0 | $0 | $0 | $5,830 | $0 | $9,890 | $0 | $201,341 | $0 | $0 | $0 |
| MARIA DILLE | ||||||||||||||
| DENTIST | $175,150 | $0 | $0 | $0 | $0 | $0 | $5,392 | $0 | $5,729 | $0 | $186,271 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PROVIDED TO THE AUDIT/FINANCE COMMITTEE FOR REVIEW. ONCE THE FORM 990 IS REVIEWED AND APPROVED BY THE COMMITTEE, IT IS MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE AUDIT COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEWS THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE, REVIEWS COMPARABLE SALARY DATA AND DECIDES ON APPROPRIATE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. |
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