GUILFORD ADULT HEALTH INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
GUILFORD ADULT HEALTH INC (EIN 04-3726317)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-06-14
IRS object ID
201901659349301160
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-06-14T15:41:44-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN561146197PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SHARRARD MCGEE & COMPANY PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 10439AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27404ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043726317EIN

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line1612 PASTEUR DR NO 108AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27408ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLISA DUCKPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3365559700PhoneNum
Signature2019-06-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGEORGE H KNOSTMANPreparerPersonNm
PTINP00235890PTIN
Phone3362729777PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.136.72.230IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-06-04IPDt
IP Tm13:54:14IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id44E5BB93025AFDF868C7A82B0EE4E39F71355CA1AtSubmissionCreationDeviceId
At Submission Filing Device Id75F49F9ADC312CF14F06616CD93A56DEFB6CECBCAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLISA DUCKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1612 PASTEUR DRIVEAddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27408ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,022,029GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GUILFORDCCN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE ACCESSIBLE, AFFORDABLE, AND QUALITY MEDICAL AND DENTAL SERVICES TO GUILFORD COUNTY RESIDENTS WITH INCOMES BETWEEN 0% AND 200% OF THE FEDERAL POVERTY LEVEL.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$570,179PYContributionsGrantsAmt
CY Contributions Grants$940,346CYContributionsGrantsAmt
PY Program Service Revenue$84,745PYProgramServiceRevenueAmt
CY Program Service Revenue$81,683CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$654,924PYTotalRevenueAmt
CY Total Revenue$1,022,029CYTotalRevenueAmt
PY Grants And Similar Paid$251,034PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$423,778CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$431,042PYOtherExpensesAmt
CY Other Expenses$291,673CYOtherExpensesAmt
PY Total Expenses$682,076PYTotalExpensesAmt
CY Total Expenses$715,451CYTotalExpensesAmt
PY Revenues Less Expenses-$27,152PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$306,578CYRevenuesLessExpensesAmt
Total Assets BOY$968,496TotalAssetsBOYAmt
Total Assets EOY$1,273,815TotalAssetsEOYAmt
Total Liabilities BOY$33,858TotalLiabilitiesBOYAmt
Total Liabilities EOY$32,599TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$934,638NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,241,216NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE LONG-TERM SECURE FUNDING FOR INDIGENT CARE AND BE AN ADVOCATE FOR THE COMMUNITY AND CLIENTS SERVED BY CLINICS IN THE AREA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$705,475ExpenseAmt
Grant$423,778GrantAmt
Revenue$81,683RevenueAmt
DescGUILFORD ADULT HEALTH PROVIDED DENTAL SERVICES TO PATIENTS BELOW POVERTY LEVEL, CREATED AND ADMINISTERED AN INFORMATION SHARING NETWORK FOR ELIGIBILITY PROCESS FOR INDIGENT PATIENTS, AND FUNDED OTHER ORGANIZATIONS PROVIDING PRIMARY MEDICAL CARE SERVICES.Desc
Total Program Service Expenses$705,475TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line1612 PASTEUR DRIVEAddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27408ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
LISA DUCK
EXECUTIVE DIRECTOR36.00Yes (X)Yes (X)$79,484$0$0
PATRICIA A SOENKSEN
CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
TIM CLONTZ
BOARD MEMBER1.00Yes (X)$0$0$0
CHESTER BROWN III
TREASURER1.00Yes (X)Yes (X)$0$0$0
MARTY LAWING
BOARD MEMBER1.00Yes (X)$0$0$0
CARIN HIOTT
VICE-CHAIR1.00Yes (X)Yes (X)$0$0$0
AASHKA MEHTA
BOARD MEMBER1.00Yes (X)$0$0$0
MICHELLE LEWIS
SECRETARY1.00Yes (X)Yes (X)$0$0$0
MERLE GREEN
BOARD MEMBER1.00Yes (X)$0$0$0
KATHY RITCH
BOARD MEMBER1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$79,484TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$126,180GovernmentGrantsAmt
All Other Contributions$814,166AllOtherContributionsAmt
Noncash Contributions$12,446NoncashContributionsAmt
Total Contributions$940,346TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSERVICE REVENUEDesc
Business624100BusinessCd
Total Revenue Column$50,384TotalRevenueColumnAmt
Related Or Exempt Func Income$50,384RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,299TotalRevenueColumnAmt
Related Or Exempt Func Income$31,299RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$81,683TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,022,029TotalRevenueColumnAmt
Related Or Exempt Func Income$81,683RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$423,778TotalAmt
Program Services$423,778ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,874TotalAmt
Program Services$678ProgramServicesAmt
Management And General$1,196ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$36,884TotalAmt
Program Services$36,884ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$135,245TotalAmt
Program Services$130,854ProgramServicesAmt
Management And General$4,391ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,825TotalAmt
Program Services$1,825ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,804TotalAmt
Program Services$13,291ProgramServicesAmt
Management And General$1,513ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$14,574TotalAmt
Program Services$14,574ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,842TotalAmt
Program Services$4,842ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,808TotalAmt
Program Services$9,808ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,058TotalAmt
Program Services$6,058ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$38,070$38,070
TELEPHONE$12,772$10,856$1,916
DUES AND SUBSCRIPTIONS$5,879$5,701$178
MISCELLANEOUS$5,118$4,924$194

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,920TotalAmt
Program Services$3,332ProgramServicesAmt
Management And General$588ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$715,451TotalAmt
Program Services$705,475ProgramServicesAmt
Management And General$9,976ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$861,035BOYAmt
EOY$1,189,534EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$64,177BOYAmt
EOY$53,407EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$593BOYAmt
EOY$998EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,878BOYAmt
EOY$870EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$73,088LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$44,082LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$38,813BOYAmt
EOY$29,006EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$968,496BOYAmt
EOY$1,273,815EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$33,858BOYAmt
EOY$32,599EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,858BOYAmt
EOY$32,599EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$487,215BOYAmt
EOY$518,901EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$447,423BOYAmt
EOY$722,315EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$934,638BOYAmt
EOY$1,241,216EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$968,496BOYAmt
EOY$1,273,815EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$306,578ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$300,190CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$673,094CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$744,598CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$570,178CurrentTaxYearMinus1YearAmt
Current Tax Year$940,346CurrentTaxYearAmt
Total$3,228,406TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$300,190CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$673,094CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$744,598CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$570,178CurrentTaxYearMinus1YearAmt
Current Tax Year$940,346CurrentTaxYearAmt
Total$3,228,406TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$580,432SubstantialContributorsTotAmt
Public Support Total170$2,647,974PublicSupportTotal170Amt
Total Support$3,228,406TotalSupportAmt
Gross Receipts Rltd Activities$286,918GrossReceiptsRltdActivitiesAmt
Public Support CY1700.82020PublicSupportCY170Pct
Public Support PY1700.79880PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$73,088OtherCostOrOtherBasisAmt
Depreciation$44,082DepreciationAmt
Book Value$29,006BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$29,006TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$1,022,029TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$1,022,029RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,022,029TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$715,451TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$715,451ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$715,451TotalExpensesPerForm990Amt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CONE HEALTH SYSTEMBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 N ELM STREETAddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27401ZIPCd
FieldValueIRS element (for citing)
Recipient EIN581588823RecipientEIN
Cash Grant$423,778CashGrantAmt
Purpose Of GrantPAYMENT OF WAGES & BENEFITSPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6CONE HEALTH AND HIGH POINT REGIONAL RECEIVE ASSETS UPON DISSOLUTION
FORM 990, PART VI, SECTION A, LINE 7ACONE HEALTH AND HIGH POINT REGIONAL RECEIVE ASSETS UPON DISSOLUTION.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE 990 WAS MADE AVAILABLE TO THE BOARD ALONG WITH THE FINANCIAL STATEMENTS FOR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED ANNUALLY BY EACH BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE DIRECTOR DEVELOPS PERFORMANCE GOALS EACH FISCAL YEAR WHICH ARE APPROVED BY THE BOARD. THE BOARD REVIEWS THE ACTUAL PERFORMANCE OF THE EXECUTIVE DIRECTOR AND COMPARES TO GOAL INITIALLY ESTABLISHED ON AN ANNUAL BASIS IN AN EFFORT TO DETERMINE HER COMPENSATION. BOARD MEMBERS ARE FROM VARIOUS ORGANIZATIONS IN THE NONPROFIT, BUSINESS, AND MEDICAL AND HUMAN SERVICES INDUSTRIES. THEY USE LABOR MARKET BASED COMPARISONS FROM THEIR RESPECTIVE ORGANIZATIONS TO DETERMINE THE EXECUTIVE DIRECTOR'S COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 18THE 990 IS MADE AVAILABLE ON PUBLIC WEBSITES, SUCH AS GUIDESTAR. IT IS ALSO AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS ARE ON FILE WITH THE EXECUTIVE DIRECTOR. INFORMATION IS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GGRANT WRITING & OTHER: PROGRAM SERVICE EXPENSES 4,201. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,201. AUDIT: PROGRAM SERVICE EXPENSES 10,762. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,762. CONSULTING FEES: PROGRAM SERVICE EXPENSES 32,999. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,999. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 37,834. MANAGEMENT AND GENERAL EXPENSES 4,391. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,225. PATIENT CARE EXPENSES: PROGRAM SERVICE EXPENSES 15,299. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,299. STIPEND: PROGRAM SERVICE EXPENSES 29,759. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,759.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR .

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

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

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