SOUTHSIDE COMMUNITY HEALTH SERVICES INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHSIDE COMMUNITY HEALTH SERVICES INC (EIN 23-7113799)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-15
- IRS object ID
- 201923199349313672
- Schema version
- 2018v3.1
- 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 | 2019-11-15T15:01:13-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 411534805 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARPENTER EVERT & ASSOCIATES LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7760 FRANCE AVE S SUITE 940 | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55435 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237113799 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHSIDE COMMUNITY HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 6128223282 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 FOURTH AVENUE SOUTH | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55409 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANN CAZABAN | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6128223282 | PhoneNum |
| Signature | 2019-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NEAL EVERT | PreparerPersonNm |
| PTIN | P00046853 | PTIN |
| Phone | 9528310085 | PhoneNum |
| Preparation | 2019-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.244.212.29 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-15 | IPDt |
| IP Tm | 14:53:13 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANN CAZABAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 FOURTH AVENUE SOUTH | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55409 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,492,133 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SOUTHSIDECHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY HEALTH CARE IN THE COMMUNITIES SERVED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 122 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,012,303 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,226,004 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,941,378 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,217,517 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,433 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $88,365 | PYOtherRevenueAmt |
| CY Other Revenue | $48,612 | CYOtherRevenueAmt |
| PY Total Revenue | $7,050,479 | PYTotalRevenueAmt |
| CY Total Revenue | $7,492,133 | 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 | $4,801,962 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,354,671 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,123,929 | PYOtherExpensesAmt |
| CY Other Expenses | $2,913,252 | CYOtherExpensesAmt |
| PY Total Expenses | $6,925,891 | PYTotalExpensesAmt |
| CY Total Expenses | $8,267,923 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $124,588 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$775,790 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,180,353 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,760,783 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,565,074 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,921,294 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $615,279 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$160,511 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SOUTHSIDE COMMUNITY HEALTH SERVICES EXISTS TO SERVE THE COMMUNITY BY OFFERING FRIENDLY, SUPERIOR, QUALITY AND FISCALLY RESPONSIBLE HEALTH SERVICES IN AN ENVIRONMENT THAT FOSTERS LEARNING AND RESPECT. IT DOES THIS THROUGH COLLABORATION AND COMMUNICATION WHICH PATIENTS ACCEPT AS AN OPPORTUNITY TO IMPROVE THEIR HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,619,753 | ExpenseAmt |
| Desc | MEDICAL: SOUTHSIDE MEDICAL CURRENTLY PROVIDES FAMILY PRACTICE MEDICINE INCLUDING SPECIAL PROGRAMS FOR AT RISK POPULATIONS, FAMILY PLANNING, PRENATAL AND PEDIATRICS. SOUTHSIDE COMMUNITY HEALTH SERVICES, INC. (SCHS) IS A 501(C)3 NONPROFIT ORGANIZATION AND IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOCATED IN SOUTH MINNEAPOLIS. SCHS HAS ONE MEDICAL CLINIC LOCATED IN MINNEAPOLIS AND A DENTAL AND VISION CLINIC LOCATED IN MINNEAPOLIS. WHILE THE MAJORITY OF PATIENTS COME FROM THE SOUTHSIDE OF MINNEAPOLIS, SCHS DRAWS PATIENTS FROM ACROSS THE TWIN CITIES METROPOLITAN AREA. SCHS CONTINUES TO HAVE AN "ESSENTIAL COMMUNITY SAFETY NET PROVIDER" DESIGNATION FROM THE STATE OF MINNESOTA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,144,200 | ExpenseAmt |
| Desc | DENTAL: SOUTHSIDE DENTAL CLINIC CURRENTLY PROVIDES GENERAL DENTAL SERVICES FOR PEOPLE OF ALL AGES. SOUTHSIDE CURRENTLY OPERATES TWELVE DENTAL OPERATORIES AND CONTINUES TO OPERATE A MOBILE DENTAL UNIT EQUIPPED WITH TWO DENTAL OPERATORIES.IN 2018, SOUTHSIDE MEDICAL AND DENTAL SERVED 3,482 UNINSURED ADULTS, 507 UNINSURED CHILDREN AND 5,007 PATIENTS ON MEDICAID. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $452,158 | ExpenseAmt |
| Desc | OUTREACH: SOUTHSIDE'S OUTREACH PROGRAM PROVIDES THE COMMUNITY WITH INNOVATIVE PROGRAMS, ACTIVITIES AND EDUCATIONAL OPPORTUNITIES DESIGNED TO IMPROVE HEALTH LITERACY AND ASSIST PEOPLE IN GETTING INVOLVED IN THEIR PERSONAL HEALTH CARE. IT HAS BEEN PROVEN THAT THE EARLIER HEALTHY PRACTICES ARE ESTABLISHED, THE BETTER THE QUALITY OF LIFE FOR THE INDIVIDUAL. THESE PRACTICES CAN INCLUDE HEALTHY DIET, CONSISTENT EXERCISE AND MONITORING LIFESTYLE CHOICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,216,111 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 122 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6128229030 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4243 FOURTH AVENUE SOUTH | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55409 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| KALEECA BIBLE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN OSBERG | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JIM GALLAGHER | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| D'WAYNE MORRIS | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KRISTY GRAUME | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHELLE EVANS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN MANIKOWSKI | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICK LYTLE | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JENNY MESSNER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LIZA SOTO | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAUN ZEIG | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAM LONGFELLOW | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| OREN AVERY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANN CAZABAN | |||||||
| EXECUTIVE DIR. | 40.00 | $133,260 | $0 | $5,019 | Yes (X) | ||
| JENNY LEE | |||||||
| FINANCE | 40.00 | $83,856 | $0 | $0 | Yes (X) | ||
| BRIAN QUINLAN | |||||||
| DENTAL DIRECTOR | 40.00 | $141,536 | $0 | $0 | Yes (X) | ||
| LIZA ORTIZ | |||||||
| MEDICAL DIRECTOR | 40.00 | $152,098 | $0 | $0 | Yes (X) | ||
| INEMIENYU AUGUSTINE EVBAKHARE | |||||||
| NURSE PRACTIONER | 40.00 | $107,765 | $0 | $0 | Yes (X) | ||
| MOHIUDDIN QUADRI | |||||||
| DENTIST | 40.00 | $129,581 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $748,096 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $5,019 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,226,004 | GovernmentGrantsAmt |
| Total Contributions | $3,226,004 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $4,217,517 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,217,517 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,217,517 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Total Revenue Column | $48,612 | TotalRevenueColumnAmt |
| Exclusion | $48,612 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $48,612 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,492,133 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,217,517 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $48,612 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,561 | TotalAmt |
| Program Services | $367,214 | ProgramServicesAmt |
| Management And General | $50,347 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,262,891 | TotalAmt |
| Program Services | $3,748,894 | ProgramServicesAmt |
| Management And General | $513,997 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,218 | TotalAmt |
| Program Services | $12,504 | ProgramServicesAmt |
| Management And General | $1,714 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,954 | TotalAmt |
| Program Services | $250,595 | ProgramServicesAmt |
| Management And General | $34,359 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,047 | TotalAmt |
| Program Services | $334,239 | ProgramServicesAmt |
| Management And General | $40,808 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,134 | TotalAmt |
| Program Services | $3,702 | ProgramServicesAmt |
| Management And General | $2,432 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,297 | TotalAmt |
| Program Services | $11,042 | ProgramServicesAmt |
| Management And General | $7,255 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,424 | TotalAmt |
| Program Services | $221,575 | ProgramServicesAmt |
| Management And General | $194,849 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379 | TotalAmt |
| Program Services | $51 | ProgramServicesAmt |
| Management And General | $328 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,074 | TotalAmt |
| Program Services | $257,672 | ProgramServicesAmt |
| Management And General | $58,402 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $343,453 | TotalAmt |
| Program Services | $294,680 | ProgramServicesAmt |
| Management And General | $48,773 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,203 | TotalAmt |
| Program Services | $183,412 | ProgramServicesAmt |
| Management And General | $21,791 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,968 | TotalAmt |
| Program Services | $10,191 | ProgramServicesAmt |
| Management And General | $7,777 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,035 | TotalAmt |
| Program Services | $7,393 | ProgramServicesAmt |
| Management And General | $5,642 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,935 | TotalAmt |
| Program Services | $584 | ProgramServicesAmt |
| Management And General | $10,351 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,618 | TotalAmt |
| Program Services | $155,471 | ProgramServicesAmt |
| Management And General | $21,147 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,669 | TotalAmt |
| Management And General | $13,669 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $927,378 | $927,378 | |
| SUPPLIES | $305,813 | $305,494 | $319 |
| MINNESOTA PROVIDERS TAX | $81,173 | $81,173 | |
| SPECIAL PROJECTS | $25,880 | $20,894 | $4,986 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,819 | TotalAmt |
| Program Services | $21,953 | ProgramServicesAmt |
| Management And General | $12,866 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,267,923 | TotalAmt |
| Program Services | $7,216,111 | ProgramServicesAmt |
| Management And General | $1,051,812 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,864 | BOYAmt |
| EOY | -$122,942 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,077 | BOYAmt |
| EOY | $2,100 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,319 | BOYAmt |
| EOY | $95,095 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $970,726 | BOYAmt |
| EOY | $902,598 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,009 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,123,697 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,243,047 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,061,076 | BOYAmt |
| EOY | $880,650 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,282 | BOYAmt |
| EOY | $3,282 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,180,353 | BOYAmt |
| EOY | $1,760,783 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,076,860 | BOYAmt |
| EOY | $1,185,827 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,200 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,462 | BOYAmt |
| EOY | $731,821 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,552 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,646 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,565,074 | BOYAmt |
| EOY | $1,921,294 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $615,279 | BOYAmt |
| EOY | -$160,511 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $615,279 | BOYAmt |
| EOY | -$160,511 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,180,353 | BOYAmt |
| EOY | $1,760,783 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$775,790 | 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 | $2,628,359 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,064,197 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,692,316 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,012,303 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,226,004 | CurrentTaxYearAmt |
| Total | $13,623,179 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,263,478 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,422,713 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,682,713 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,941,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,076,077 | CurrentTaxYearAmt |
| Total | $21,386,359 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,891,837 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,486,910 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,375,029 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,953,681 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,302,081 | CurrentTaxYearAmt |
| Total | $35,009,538 | 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 | $35,009,538 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $433 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $546 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $433 | CurrentTaxYearMinus1YearAmt |
| Total | $546 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,865 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,167 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $88,492 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $88,365 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $48,612 | CurrentTaxYearAmt |
| Total | $250,501 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,905,756 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,498,099 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,463,558 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,042,479 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,350,693 | CurrentTaxYearAmt |
| Total | $35,260,585 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99290 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99330 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2014 AMOUNT: $ 13,865. 2015 AMOUNT: $ 11,167. 2016 AMOUNT: $ 88,492. 2017 AMOUNT: $ 88,365. 2018 AMOUNT: $ 48,612. | ExplanationTxt |
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 | $130,543 | OtherCostOrOtherBasisAmt |
| Book Value | $130,543 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,095,609 | OtherCostOrOtherBasisAmt |
| Depreciation | $585,881 | DepreciationAmt |
| Book Value | $509,728 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $315,603 | OtherCostOrOtherBasisAmt |
| Depreciation | $454,296 | DepreciationAmt |
| Book Value | -$138,693 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,581,942 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,202,870 | DepreciationAmt |
| Book Value | $379,072 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $880,650 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDABLE ADVANCES | Desc |
| Amt | $3,646 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,646 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,492,133 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,492,133 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,492,133 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,267,923 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,267,923 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,267,923 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS A TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS ADOPTED ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ASC 740-10. THE ORGANIZATIONS POLICY IS TO EVALUATE UNCERTAIN TAX POSITIONS, AT LEAST ANNUALLY, FOR THE POTENTIAL FOR INCOME TAX EXPOSURE FROM UNRELATED BUSINESS INCOME OR FROM LOSS OF NONPROFIT STATUS. THE ORGANIZATION CONTINUES TO OPERATE CONSISTENT WITH ITS ORIGINAL EXEMPTION APPLICATION AND EACH YEAR TAKES THE NECESSARY ACTIONS TO MAINTAIN ITS EXEMPT STATUS. IT HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER THE INTERNAL REVENUE CODE AND CHARITABLE CONTRIBUTIONS BY DONORS ARE TAX DEDUCTIBLE. IN COMPLIANCE WITH ITS EXEMPT STATUS, THE ORGANIZATION ANNUALLY FILES A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990). THE RETURNS FOR THE YEARS ENDING DECEMBER 31, 2013 AND LATER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LIZA ORTIZ | PersonNm |
| Title | MEDICAL DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $152,098 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $152,098 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | LINE 11B EXPLANATION - A DRAFT OF THE 990 IS PRESENTED TO THE EXECUTIVE COMMITTEE FOR REVIEW AND QUESTIONS. ONCE APPROVED BY THE COMMITTE, THE 990 WILL BE FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE UPDATED ANNUALLY FOR ALL BOARD MEMBERS AND EMPLOYEES. ANY CONFLICT OF INTEREST MUST BE IMMEDIATELY DISCLOSED TO THE EXECUTIVE DIRECTOR IN WRITING. NO MEMBER OF THE BOARD MAY VOTE ON MATTERS ON ANY AREA WHERE THEY MAY RECEIVE FINANCIAL GAIN OR WHICH MAY CONFLICT WITH MEMBER OBLIGATIONS. DAILY MONITORING ON PATIENT CARE. ANY ISSUES ARE PRESENTED AT MONTHLY QUALITY AND RISK COMMITTEE MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR REVIEWS AND APRROVES THE COMPENSATION OF THE OTHER OFFICERS USING A MARKET SURVEY CONDUCTED BY AN OUTSIDE HR CONSULTANT. THE EXECUTIVE COMMITTEE USED EXECUTIVE SALARY SURVEYS FOR COMPARABILITY PURPOSES TO UPDATE THE EXECUTIVE DIRECTOR'S COMPENSATION. THE DECISION OF THE EXECUTIVE COMMITTEE WAS ALSO REVEIWED AND APPROVED BY THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC. |
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