MS COMPREHENSIVE CARE CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MS COMPREHENSIVE CARE CENTER (EIN 22-2402959)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201843199349301819
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T07:27:23-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WithumSmithBrown PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Jefferson Park Suite 400 | AddressLine1Txt |
| City | Whippany | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 079811070 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222402959 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MS COMPREHENSIVE CARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RYAN KENNEDY CPA | InCareOfNm |
| Business Name Control | MSCO | BusinessNameControlTxt |
| Phone | 2018337016 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1Txt |
| City | TEANECK | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07666 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN KENNEDY | PersonNm |
| Person Title | CFP | PersonTitleTxt |
| Phone | 2018337016 | PhoneNum |
| Signature | 2018-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Scott J Mariani | PreparerPersonNm |
| PTIN | P00642486 | PTIN |
| Phone | 9738989494 | PhoneNum |
| Preparation | 2018-11-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 148.77.36.74 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 22006220183195000043 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9751BF644BFBD5F9C605379BF4EDEFD47391394C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B4F49B62ABB70139397F9A781BA9C9E9BE652F2C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL MARON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1Txt |
| City | TEANECK | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07666 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,110,309 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOLYNAME.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT THE CHARITABLE PURPOSES OF HOLY NAME MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION REGARDING MS SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 11 | TotalEmployeeCnt |
| Total Volunteers | 45 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $308,206 | PYContributionsGrantsAmt |
| CY Contributions Grants | $266,753 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $709,523 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $753,925 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,231 | PYOtherRevenueAmt |
| CY Other Revenue | $9,714 | CYOtherRevenueAmt |
| PY Total Revenue | $1,025,960 | PYTotalRevenueAmt |
| CY Total Revenue | $1,030,392 | 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 | $1,425,353 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,473,910 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $427,476 | PYOtherExpensesAmt |
| CY Other Expenses | $417,148 | CYOtherExpensesAmt |
| PY Total Expenses | $1,852,829 | PYTotalExpensesAmt |
| CY Total Expenses | $1,891,058 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$826,869 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$860,666 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $283,261 | TotalAssetsBOYAmt |
| Total Assets EOY | $293,615 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,551,666 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,422,686 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,268,405 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$5,129,071 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION'S MISSION, SINCE INCEPTION, IS TO PROVIDE COMPREHENSIVE AND HUMANE CARE TO PATIENTS WITH MULTIPLE SCLEROSIS AND THEIR FAMILIES. THE OVERALL GOAL OF CARE IS MAINTENANCE OF THE PATIENT'S HIGHEST LEVEL OF INDEPENDENCE IN THEIR HOME AND WORK ENVIRONMENT WHILE MAINTAINING SAFETY AND COMFORT. THE MS COMPREHENSIVE CARE CENTER AT HOLY NAME MEDICAL CENTER IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. THE ORGANIZATION PROVIDES MULTIPLE SCLEROSIS SERVICES, RESEARCH AND EDUCATION. THE ORGANIZATION IS a SUBSIDIARY OF HOLY NAME MEDICAL CENTER, AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. THE BERNARD GIMBEL MS CENTER OPENED IN 1985 AT (THEN) HOLY NAME HOSPITAL AS AN INDEPENDENT ENTITY. THE CENTER WAS OPEN TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. AT THAT TIME THE STAFF CONSISTED OF A NEUROLOGIST, A NURSE AND A VOLUNTEER. MEDICAL CARE CENTERED ON DIAGNOSIS AND SYMPTOMATIC MANAGEMENT ON AN OUTPATIENT BASIS. THE COMPREHENSIVE INTERDISC | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,701,953 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $753,925 | RevenueAmt |
| Desc | EXPENSES INCURRED IN SUPPORTING THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HOLY NAME MEDICAL CENTER SPECIFICALLY CENTERED ON MS SERVICES. HOLY NAME MEDICAL CENTER IS A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION, WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $1,701,953 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | Yes (true) | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 11 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN KENNEDY CPA | PersonNm |
| Phone | 2018337016 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1Txt |
| City | TEANECK | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07666 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOHN M GERAGHTY | |||||||||
| CHAIRPERSON - TRUSTEE | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH A FRASCINO MD | |||||||||
| VICE CHAIRPERSON - TRUSTEE | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SISTER BARBARA MORAN CSJP | |||||||||
| SECRETARY - TRUSTEE | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EDWIN H RUZINSKY CPA | |||||||||
| TREASURER - TRUSTEE | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID BUTLER MD | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| TED A CARNEVALE CPA | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DALE A CREAMER | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MAUREEN DONAHUE | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL R DRESSLER ESQ | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| FERNANDO GARIP | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID E LANDERS MD | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SALVATORE LARAIA MD | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL LEBER | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL MARON | |||||||||
| TRUSTEE - PRESIDENT/CEO | 55.0 | 0.0 | Yes (X) | Yes (X) | $0 | $2,456,631 | $554,669 | ||
| SISTER ANTOINETTE MOORE CSJP | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JOSEPH PARISI JR | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MYRON ROSNER ESQ | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| LEON TEMIZ | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| RONALD WHITE MD | |||||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| RYAN KENNEDYCPA | |||||||||
| VP/CHIEF FINANCIAL OFFICER | 55.0 | 0.0 | Yes (X) | $0 | $438,178 | $99,433 | |||
| MARY ANN PICONE MD | |||||||||
| MEDICAL DIRECTOR | 55.0 | 0.0 | $402,624 | $0 | $32,499 | Yes (X) | |||
| DAVID DUNCAN MD | |||||||||
| PHYSICIAN | 55.0 | 0.0 | $273,436 | $0 | $21,228 | Yes (X) | |||
| ROSEMARIE A RAGUINDIN RN | |||||||||
| REGISTERED NURSE | 55.0 | 0.0 | $126,427 | $0 | $29,931 | Yes (X) | |||
| KAREN BLITZ-SHABBIR MD | |||||||||
| PHYSICIAN | 55.0 | 0.0 | $110,292 | $0 | $12,775 | Yes (X) | |||
| REENA R MATHEW RN | |||||||||
| REGISTERED NURSE | 55.0 | 0.0 | $109,555 | $0 | $29,441 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,022,334 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,894,809 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $779,976 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Fundraising | $249,180 | FundraisingAmt |
| All Other Contributions | $17,573 | AllOtherContributionsAmt |
| Total Contributions | $266,753 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 541900 | $661,149 | $661,149 |
| OTHER HEALTHCARE RELATED REVENUE | 541900 | $92,776 | $92,776 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $753,925 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $71,671 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $249,180 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $71,671 | FundraisingDirectExpensesAmt |
| Gaming Gross Income | $17,960 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $8,246 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,714 | TotalRevenueColumnAmt |
| Exclusion | $9,714 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,030,392 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $753,925 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $9,714 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,123 | TotalAmt |
| Program Services | $391,611 | ProgramServicesAmt |
| Management And General | $43,512 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $816,087 | TotalAmt |
| Program Services | $734,478 | ProgramServicesAmt |
| Management And General | $81,609 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,718 | TotalAmt |
| Program Services | $24,946 | ProgramServicesAmt |
| Management And General | $2,772 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,980 | TotalAmt |
| Program Services | $112,482 | ProgramServicesAmt |
| Management And General | $12,498 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,002 | TotalAmt |
| Program Services | $63,002 | ProgramServicesAmt |
| Management And General | $7,000 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,333 | TotalAmt |
| Program Services | $21,000 | ProgramServicesAmt |
| Management And General | $2,333 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,925 | TotalAmt |
| Program Services | $51,232 | ProgramServicesAmt |
| Management And General | $5,693 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $620 | TotalAmt |
| Program Services | $558 | ProgramServicesAmt |
| Management And General | $62 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,257 | TotalAmt |
| Program Services | $15,531 | ProgramServicesAmt |
| Management And General | $1,726 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,237 | TotalAmt |
| Program Services | $73,113 | ProgramServicesAmt |
| Management And General | $8,124 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,187 | TotalAmt |
| Program Services | $3,768 | ProgramServicesAmt |
| Management And General | $419 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,274 | TotalAmt |
| Program Services | $2,947 | ProgramServicesAmt |
| Management And General | $327 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,722 | TotalAmt |
| Program Services | $7,850 | ProgramServicesAmt |
| Management And General | $872 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,359 | TotalAmt |
| Program Services | $30,023 | ProgramServicesAmt |
| Management And General | $3,336 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $162,970 | $146,673 | $16,297 |
| REPAIRS & MAINTENANCE | $18,119 | $16,307 | $1,812 |
| PERMITS & DUES | $7,145 | $6,432 | $713 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,891,058 | TotalAmt |
| Program Services | $1,701,953 | ProgramServicesAmt |
| Management And General | $189,105 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50 | BOYAmt |
| EOY | $50 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,687 | BOYAmt |
| EOY | $86,771 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,125 | BOYAmt |
| EOY | $117,142 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,421 | BOYAmt |
| EOY | $6,981 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $255,412 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $202,016 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,119 | BOYAmt |
| EOY | $53,396 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,859 | BOYAmt |
| EOY | $29,275 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,261 | BOYAmt |
| EOY | $293,615 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,859 | BOYAmt |
| EOY | $80,252 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $350 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,456,807 | BOYAmt |
| EOY | $5,342,084 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,551,666 | BOYAmt |
| EOY | $5,422,686 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,268,405 | BOYAmt |
| EOY | -$5,129,071 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,268,405 | BOYAmt |
| EOY | -$5,129,071 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,261 | BOYAmt |
| EOY | $293,615 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$860,666 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
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 | $131,656 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $220,362 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $236,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $308,206 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $266,753 | CurrentTaxYearAmt |
| Total | $1,163,747 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $402,086 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $540,872 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $704,482 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $797,086 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $843,556 | CurrentTaxYearAmt |
| Total | $3,288,082 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $533,742 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $761,234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $941,252 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,105,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,110,309 | CurrentTaxYearAmt |
| Total | $4,451,829 | 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 | $4,451,829 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $533,742 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $761,234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $941,252 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,105,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,110,309 | CurrentTaxYearAmt |
| Total | $4,451,829 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $255,412 | OtherCostOrOtherBasisAmt |
| Depreciation | $202,016 | DepreciationAmt |
| Book Value | $53,396 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $53,396 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER RECEIVABLES | Desc |
| Book Value | $29,275 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $29,275 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO HOLY NAME MEDICAL CENTER | Desc |
| Amt | $5,342,084 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,342,084 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FASHION SHOW | Event1Nm |
| Gross Receipts Event1 | $197,191 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $151,468 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $45,723 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $0 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $0 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $0 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $26,970 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $3,500 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $15,253 | OtherDirectExpensesEvent1Amt |
| Event2 | AWARDS DINNER | Event2Nm |
| Gross Receipts Event2 | $123,660 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $97,712 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $25,948 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $0 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $0 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $0 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $13,790 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $595 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $11,563 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $320,851 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $249,180 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $71,671 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $0 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $0 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $0 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $40,760 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $4,095 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $26,816 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $71,671 | DirectExpenseSummaryEventsAmt |
Gaming Information GamingInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | $17,960 | GrossRevenueOtherGamingAmt |
| Cash Prizes Other Gaming | $7,880 | CashPrizesOtherGamingAmt |
| Oth Direct Expnss Other Gaming | $366 | OthDirectExpnssOtherGamingAmt |
| Volunteer Labor Other Gaming | false | VolunteerLaborOtherGamingInd |
| Gross Revenue Total Gaming | $17,960 | GrossRevenueTotalGamingAmt |
| Cash Prizes Total Gaming | $7,880 | CashPrizesTotalGamingAmt |
| Oth Direct Expnss Total Gaming | $366 | OthDirectExpnssTotalGamingAmt |
| Direct Expense Summary Gaming | $8,246 | DirectExpenseSummaryGamingAmt |
| Net Gaming Income Summary | $9,714 | NetGamingIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | NJ | StatesWhereGamingConductedCd |
| Licensed | Yes (true) | LicensedInd |
| License Suspended Etc | false | LicenseSuspendedEtcInd |
| Gaming With Nonmembers | Yes (true) | GamingWithNonmembersInd |
| Member Of Other Entity | false | MemberOfOtherEntityInd |
| Gaming Own Facility | 1.00000 | GamingOwnFacilityPct |
| Individual With Books | HOLY NAME HEALTH CARE FOUNDATION ST | IndividualWithBooksNm |
Persons With Books US Address PersonsWithBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1Txt |
| City | TEANECK | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 07666 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct With3rd Prty For Game Rev | false | CntrctWith3rdPrtyForGameRevInd |
| Gaming Manager Person | MOLLY MCGARRY | GamingManagerPersonNm |
| Gaming Manager Compensation | $0 | GamingManagerCompensationAmt |
| Gaming Manager Services Prov | SALE OF TICKETS, KEEPER OF RECORDS | GamingManagerServicesProvTxt |
| Gaming Manager Is Employee | Yes (X) | GamingManagerIsEmployeeInd |
| Charitable Distribution Rqr | false | CharitableDistributionRqrInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE G, PART III; QUESTION 16 | FormAndLineReferenceDesc |
| Explanation | MOLLY MCGARRY IS A FULL-TIME EMPLOYEE OF HOLY NAME MEDICAL CENTER FOUNDATION, INC. BUT IS COMPENSATED FROM HOLY NAME MEDICAL CENTER. A SMALL PORTION OF HER TIME IS DEVOTED TO GAMING MANAGEMENT. PLEASE REFER TO THE HOLY NAME MEDICAL CENTER FOUNDATION, INC. FEDERAL FORM 990 FOR THE PORTION OF HER TOTAL COMPENSATION THAT IS DEVOTED TO GAMING MANAGEMENT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL MARON | ||||||||||||||
| TRUSTEE - PRESIDENT/CEO | $0 | $1,194,871 | $0 | $1,225,000 | $0 | $36,760 | $0 | $529,708 | $0 | $24,961 | $0 | $3,011,300 | $0 | $0 |
| RYAN KENNEDYCPA | ||||||||||||||
| VP/CHIEF FINANCIAL OFFICER | $0 | $417,478 | $0 | $0 | $0 | $20,700 | $0 | $71,654 | $0 | $27,779 | $0 | $537,611 | $0 | $0 |
| MARY ANN PICONE MD | ||||||||||||||
| MEDICAL DIRECTOR | $400,804 | $0 | $0 | $0 | $1,820 | $0 | $10,800 | $0 | $21,699 | $0 | $435,123 | $0 | $0 | $0 |
| DAVID DUNCAN MD | ||||||||||||||
| PHYSICIAN | $272,268 | $0 | $0 | $0 | $1,168 | $0 | $10,800 | $0 | $10,428 | $0 | $294,664 | $0 | $0 | $0 |
| ROSEMARIE A RAGUINDIN RN | ||||||||||||||
| REGISTERED NURSE | $125,814 | $0 | $0 | $0 | $613 | $0 | $4,702 | $0 | $25,229 | $0 | $156,358 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I; QUESTION 4B | THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2017 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: MICHAEL MARON, $518,908 and RYAN KENNEDY, CPA, $60,854. |
| SCHEDULE J, PART I; QUESTION 7 | AN INDIVIDUAL INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2017 WHICH WAS INCLUDED IN COLUMN B(II) HEREIN AND IN THE INDIVIDUAL'S 2017 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | HOLY NAME MEDICAL CENTER ("HNMC") IS THE SOLE MEMBER OF THIS ORGANIZATION. PEACE MINISTRIES, INC. IS THE SOLE MEMBER OF HNMC. PEACE MINISTRIES, INC. HAS THE ULTIMATE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. |
| CORE FORM, PART VI, SECTION B; QUESTION 11b | THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM, WHICH INCLUDES HOLY NAME MEDICAL CENTER, INC. ("HNMC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION. THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). HNMC'S AUDIT COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE SYSTEM'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS INCLUDING, BUT NOT LIMITED TO, THE CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT OF FINANCE AND CONTROLLER ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FORM 990 WAS THEN PROVIDED TO HNMC'S AUDIT COMMITTEE AND SUBSEQUENTLY TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM, WHICH INCLUDES HOLY NAME MEDICAL CENTER, INC. ("HNMC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION. THE ORGANIZATION AND SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO HNMC'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER, THE CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS WHICH IS THEN PRESENTED TO HNMC'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM, WHICH INCLUDES HOLY NAME MEDICAL CENTER, INC. ("HNMC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION. HNMC'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF ALL HOLY NAME MEDICAL CENTER VICE PRESIDENTS AND ABOVE ("SENIOR MANAGEMENT PERSONNEL"). THIS INCLUDES BUT IS NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER and VICE PRESIDENT/CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THESE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS WITHIN THE ORGANIZATION ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM HNMC'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. |
| CORE FORM, PART VII AND SCHEDULE J | CORE FORM, PART VII AND SCHEDULE J REFLECTS CERTAIN TRUSTEES AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM, WHICH INCLUDES HOLY NAME MEDICAL CENTER, INC. ("HNMC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION. CERTAIN BOARD OF TRUSTEE MEMBERS AND OFFICERS INCLUDED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID KEY EMPLOYEES OR OFFICERS, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM, WHICH INCLUDES HOLY NAME MEDICAL CENTER, INC. ("HNMC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES, FOR THE YEARS ENDED DECEMBER 31, 2017 AND DECEMBER 31, 2016; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. HNMC'S AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PEACE MINISTRIES INC | ||||||||||
| 399 HUDSON TERRACE | ENGLEWOOD CLIFFS | NJ | 07632 | 465202238 | RELIGIOUS ORD | NJ | 501(C)(3) | 509(A)(1) | NA | false |
| HOLY NAME MEDICAL CENTER | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 221487322 | HEALTHCARE | NJ | 501(C)(3) | HOSPITAL | PEACE MIN | false |
| HOLY NAME REAL ESTATE CORP | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223412504 | PROPERTY CO | NJ | 501(C)(3) | 509(A)(3) | HNMC | false |
| HOLY NAME HEALTH CARE FOUNDATION | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 222737143 | FUNDRAISING | NJ | 501(C)(3) | 509(A)(3) | HNMC | false |
| HOLY NAME EMS INC | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 270294681 | HEALTHCARE | NJ | 501(C)(3) | 509(A)(3) | HNMC | false |
| THE CRUDEM FOUNDATION INC | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 431660199 | FUNDRAISING | MO | 501(C)(3) | 509(A)(1) | HNHC FDN | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTH PARTNER SERVICES INC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223618636 | MGMT SERVICES | NJ | NA | C CORP. | false |
| PEACE HEALTH PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223618634 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| HOUSE PHYSICIAN PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223808427 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| HEMATOLOGY ONCOLOGY PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223808421 | INACTIVE | NJ | NA | C CORP. | false |
| RIVERSIDE FAMILY PRACTICE PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 200446233 | INACTIVE | NJ | NA | C CORP. | false |
| RADIATION ONCOLOGY PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 201104758 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| EXCELCARE MEDICAL ASSOCIATES PA | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 203130405 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| BREAST IMAGING PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 753226059 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| HOLY NAME CARDIOLOGY ASSOCIATES PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 753226063 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| BREAST CARE PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 113787403 | INACTIVE | NJ | NA | C CORP. | false |
| HOLY NAME PULMONARY ASSOCIATES PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 830511119 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| WOMEN'S CLINIC PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 364635222 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| MULKAY CARDIOLOGY CONSULTANTS AT HNMC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 463392343 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| HN PRIMARY CARE & SPECIALTY ASSOC PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 463825486 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| PRIMARY CARE OF ORADELL | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 474651750 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| HOLY NAME MEDICAL ASSOCIATES PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 474693593 | HEALTHCARE SVCS | NJ | NA | C CORP. | false |
| NORTH JERSEY MEDICAL ASSOCIATES PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 474680926 | INACTIVE | NJ | NA | C CORP. | false |
| NORTH JERSEY MEDICAL PARTNERS PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 474669357 | INACTIVE | NJ | NA | C CORP. | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY NAME MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | E | TransactionTypeTxt |
| Involved | $828,053 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM, WHICH INCLUDES HOLY NAME MEDICAL CENTER, INC. ("HNMC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION. HNMC ROUTINELY PAYS EXPENSES FOR VARIOUS RELATED AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED. | ExplanationTxt |
Comments