FREDERICK HEALTH HOSPICE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
FREDERICK HEALTH HOSPICE INC (EIN 52-1164513)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201821359349312987
Schema version
2016v3.1
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

FieldValueIRS element (for citing)
Return2018-05-15T19:55:02-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 NORTH FRANKLIN STREET STE 2400AddressLine1Txt
CityTAMPACityNm
State AbbreviationFLStateAbbreviationCd
ZIP33602ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521164513EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF FREDERICK COUNTY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MICHELLE MAHANInCareOfNm
Business Name ControlHOSPBusinessNameControlTxt
Phone2405663030PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1799AddressLine1Txt
CityFREDERICKCityNm
State AbbreviationMDStateAbbreviationCd
ZIP21705ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHELLE MAHANPersonNm
Person TitleCFO-FMH, INC.PersonTitleTxt
Phone2405663300PhoneNum
Signature2018-05-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMELANIE A MCPEAKPreparerPersonNm
PTINP01346034PTIN
Phone8132234800PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMICHELLE MAHANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 WEST SEVENTH STREETAddressLine1Txt
CityFREDERICKCityNm
State AbbreviationMDStateAbbreviationCd
ZIP21701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,450,753GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOSPICEOFFREDERICKCO.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateMDLegalDomicileStateCd
Activity Or MissionProvide and promote hospice care for people who are terminally ill and for their families. it serves as a fundraising org. for the benefit of hospice svcs. and the kline house.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$963,381PYContributionsGrantsAmt
CY Contributions Grants$1,064,727CYContributionsGrantsAmt
PY Program Service Revenue$184,660PYProgramServiceRevenueAmt
CY Program Service Revenue$227,073CYProgramServiceRevenueAmt
PY Investment Income$50,443PYInvestmentIncomeAmt
CY Investment Income$231,891CYInvestmentIncomeAmt
PY Other Revenue$191,589PYOtherRevenueAmt
CY Other Revenue$212,638CYOtherRevenueAmt
PY Total Revenue$1,390,073PYTotalRevenueAmt
CY Total Revenue$1,736,329CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
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$15,814CYTotalFundraisingExpenseAmt
PY Other Expenses$1,208,467PYOtherExpensesAmt
CY Other Expenses$1,218,652CYOtherExpensesAmt
PY Total Expenses$1,208,467PYTotalExpensesAmt
CY Total Expenses$1,218,652CYTotalExpensesAmt
PY Revenues Less Expenses$181,606PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$517,677CYRevenuesLessExpensesAmt
Total Assets BOY$4,936,027TotalAssetsBOYAmt
Total Assets EOY$5,331,128TotalAssetsEOYAmt
Total Liabilities BOY$118,913TotalLiabilitiesBOYAmt
Total Liabilities EOY$120,862TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,817,114NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,210,266NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PURPOSE OF THE HOSPICE OF FREDERICK COUNTY, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. HOSPICE OF FREDERICK COUNTY, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,088,460ExpenseAmt
Revenue$227,073RevenueAmt
DescTHE PURPOSE OF THE HOSPICE OF FREDERICK COUNTY, INC. IS TO PROVIDE AND PROMOTE HOSPICE CARE FOR INDIVIDUALS WHO ARE TERMINALLY ILL AND FOR THEIR FAMILIES. HOSPICE OF FREDERICK COUNTY, INC. OPERATES AS A FUNDRAISING ORGANIZATION FOR THE BENEFIT OF HOSPICE SERVICES AND OPERATES THE KLINE HOSPICE HOUSE.Desc
Total Program Service Expenses$1,088,460TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMDStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMICHELLE MAHANPersonNm
Phone2405663300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 WEST SEVENTH STREETAddressLine1Txt
CityFREDERICKCityNm
State AbbreviationMDStateAbbreviationCd
ZIP21701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Thomas Kleinhanzl
Director3.037.0Yes (X)$0$1,089,396$248,858
Carl Miller
Director4.00.0Yes (X)$0$0$0
Ricky Sandy
PRESIDENT2.00.0Yes (X)$0$0$0Yes (X)
Douglas Stauffer
Director2.00.0Yes (X)$0$0$0
John Verbus
Director5.035.0Yes (X)$0$425,229$55,066
Mark Goldstein MD
Director2.040.0Yes (X)$0$444,912$32,906
Rev Timothy May
Secretary2.00.0Yes (X)$0$0$0Yes (X)
Don Butt Jr
Treasurer (thru 6/22/17)2.00.0Yes (X)$0$0$0Yes (X)
Jeanie Cronin
Director1.00.0Yes (X)$0$0$0
Alyce Luck
Director1.00.0Yes (X)$0$0$0
Kathy Weishaar MD
director1.00.0Yes (X)$0$0$0
PATRICK JOHANNES MANSKY
DIRECTOR (start 6/22/17)1.00.0Yes (X)$0$492,676$8,976
Timothy A Gibian PsyD
Director1.00.0Yes (X)$0$0$0
William Haugh
Vice President2.00.0Yes (X)$0$0$0Yes (X)
Carmen Hernandez MD
Director (thru 6/22/17)1.00.0Yes (X)$0$0$0
Laurel Cucchi
Director Operations55.00.0$0$136,998$13,038Yes (X)
Michelle Mahan
Chief Financial Officer - FMH3.037.0$0$653,744$56,519Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,242,955TotReportableCompRltdOrgAmt
Total Other Compensation$415,363TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$49,110FundraisingAmt
All Other Contributions$1,015,617AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$1,064,727TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescINPATIENT - HOSPICE HOUSEDesc
Business623110BusinessCd
Total Revenue Column$227,073TotalRevenueColumnAmt
Related Or Exempt Func Income$227,073RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$227,073TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$113,072TotalRevenueColumnAmt
Exclusion$113,072ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,804,793SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,685,974SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$118,819SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$118,819TotalRevenueColumnAmt
Exclusion$118,819ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$241,088FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$49,110ContriRptFundraisingEventAmt
Fundraising Direct Expenses$28,450FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$212,638TotalRevenueColumnAmt
Exclusion$212,638ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,736,329TotalRevenueColumnAmt
Related Or Exempt Func Income$227,073RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$444,529ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$42,629TotalAmt
Program Services$0ProgramServicesAmt
Management And General$42,629ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$76,725TotalAmt
Program Services$55,663ProgramServicesAmt
Management And General$13,893ManagementAndGeneralAmt
Fundraising$7,169FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$16,166TotalAmt
Program Services$15,985ProgramServicesAmt
Management And General$76ManagementAndGeneralAmt
Fundraising$105FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$67,919TotalAmt
Program Services$67,919ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES & COGS$122,781$99,308$14,933$8,540
RELATED PARTY SVC FEES$892,432$849,585$42,847$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,218,652TotalAmt
Program Services$1,088,460ProgramServicesAmt
Management And General$114,378ManagementAndGeneralAmt
Fundraising$15,814FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$412,412BOYAmt
EOY$500,127EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$42,951BOYAmt
EOY$10,580EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,892,606LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,093,348LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$848,086BOYAmt
EOY$799,258EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,632,578BOYAmt
EOY$4,021,163EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,936,027BOYAmt
EOY$5,331,128EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$118,913BOYAmt
EOY$120,862EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$118,913BOYAmt
EOY$120,862EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,817,114BOYAmt
EOY$5,210,266EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,817,114BOYAmt
EOY$5,210,266EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,936,027BOYAmt
EOY$5,331,128EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$517,677ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$137,233NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$261,758OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$710,342CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$979,996CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$912,801CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$963,381CurrentTaxYearMinus1YearAmt
Current Tax Year$1,064,727CurrentTaxYearAmt
Total$4,631,247TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$237,820CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$202,260CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$243,560CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$184,660CurrentTaxYearMinus1YearAmt
Current Tax Year$227,073CurrentTaxYearAmt
Total$1,095,373TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$47,655CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46,650CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$226,239CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$224,512CurrentTaxYearMinus1YearAmt
Current Tax Year$241,088CurrentTaxYearAmt
Total$786,144TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$995,817CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,228,906CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,382,600CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,372,553CurrentTaxYearMinus1YearAmt
Current Tax Year$1,532,888CurrentTaxYearAmt
Total$6,512,764TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$46,936CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$229,797CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$288,684CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$604,004CurrentTaxYearMinus1YearAmt
Current Tax Year$100,629CurrentTaxYearAmt
Total$1,270,050TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$46,936CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$229,797CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$288,684CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$604,004CurrentTaxYearMinus1YearAmt
Current Tax Year$100,629CurrentTaxYearAmt
Total$1,270,050TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$5,242,714PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$100,816CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$112,306CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$175,347CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$115,311CurrentTaxYearMinus1YearAmt
Current Tax Year$113,072CurrentTaxYearAmt
Total$616,852TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$100,816CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$112,306CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$175,347CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$115,311CurrentTaxYearMinus1YearAmt
Current Tax Year$113,072CurrentTaxYearAmt
Total$616,852TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,096,633CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,341,212CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,557,947CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,487,864CurrentTaxYearMinus1YearAmt
Current Tax Year$1,645,960CurrentTaxYearAmt
Total$7,129,616TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.73534PublicSupportCY509Pct
Public Support PY5090.63527PublicSupportPY509Pct
Investment Income CY0.08652InvestmentIncomeCYPct
Investment Income PY0.07533InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$145,000OtherCostOrOtherBasisAmt
Book Value$145,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,334,057OtherCostOrOtherBasisAmt
Depreciation$721,863DepreciationAmt
Book Value$612,194BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$227,799OtherCostOrOtherBasisAmt
Depreciation$225,988DepreciationAmt
Book Value$1,810BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$185,751OtherCostOrOtherBasisAmt
Depreciation$145,497DepreciationAmt
Book Value$40,254BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$799,258TotalBookValueLandBuildingsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOURMET TASTEEvent1Nm
Gross Receipts Event1$57,090GrossReceiptsEvent1Amt
Charitable Contri Event1$46,010CharitableContriEvent1Amt
Gross Revenue Event1$11,080GrossRevenueEvent1Amt
Non Cash Prizes Event1$500NonCashPrizesEvent1Amt
Rent Facility Costs Event1$1,694RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$3,372OtherDirectExpensesEvent1Amt
Event2GOLF TOURNEYEvent2Nm
Gross Receipts Event2$233,108GrossReceiptsEvent2Amt
Charitable Contri Event2$3,100CharitableContriEvent2Amt
Gross Revenue Event2$230,008GrossRevenueEvent2Amt
Non Cash Prizes Event2$1,916NonCashPrizesEvent2Amt
Rent Facility Costs Event2$18,455RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$2,513OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$290,198GrossReceiptsTotalAmt
Charitable Contributions Tot$49,110CharitableContributionsTotAmt
Gross Revenue Total Events$241,088GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$2,416NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$20,149RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$5,885OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$28,450DirectExpenseSummaryEventsAmt
Net Income Summary$212,638NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Thomas Kleinhanzl
Director$0$834,039$0$242,384$0$12,973$0$230,527$0$18,331$0$1,338,254$0$0
John Verbus
Director$0$340,381$0$81,284$0$3,564$0$40,743$0$14,323$0$480,295$0$0
Laurel Cucchi
Director Operations$0$136,476$0$0$0$522$0$5,354$0$7,684$0$150,036$0$0
Michelle Mahan
Chief Financial Officer - FMH$0$548,382$0$101,798$0$3,564$0$38,188$0$18,331$0$710,263$0$0
Mark Goldstein MD
Director$0$258,662$0$186,010$0$240$0$14,575$0$18,331$0$477,818$0$0
PATRICK JOHANNES MANSKY
DIRECTOR (start 6/22/17)$0$426,815$0$65,345$0$516$0$6,625$0$2,351$0$501,652$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SCHEDULE J, PART I, LINE 3THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO CARRY OUT THE HEALTH SYSTEM MISSION, TO ACHIEVE THE CHARITABLE PURPOSE, TO ATTRACT, RETAIN, MOTIVATE AND REWARD EXECUTIVE MANAGEMENT, AND TO MAINTAIN A COMPETITIVE POSITION WITH PEER ORGANIZATIONS IN THE REGION. OVERSIGHT OF THE EXECUTIVE COMPENSATION PROGRAM IS PROVIDED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD, COMPOSED OF THE BOARD CHAIRMAN, VICE CHAIRMAN, IMMEDIATE PRECEDING CHAIRMAN, CHAIRMAN OF THE FINANCE COMMITTEE AND THE CHAIRMAN OF THE GOVERNANCE COMMITTEE. IN ADDITION TO THE BOARD'S COMPENSATION COMMITTEE, WE UTILIZED AN EXTERNAL INDEPENDENT CONSULTANT AND MARKET SURVEYS FOR ALL EXECUTIVE MANAGEMENT COMPENSATION. THE PRESIDENT AND CEO HAS A WRITTEN EMPLOYMENT CONTRACT.
FORM 990, SCHEDULE J, PART I, LINE 4BFREDERICK MEMORIAL HOSPITAL HAS ONE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR MANAGEMENT. UNDER THE PLAN, THEY MAY CONTRIBUTE AMOUNTS FROM THEIR COMPENSATION TO THE PLAN AND MAY RECEIVE A DISCRETIONARY EMPLOYER CONTRIBUTION. EMPLOYEES ARE FULLY VESTED IN ALL EMPLOYEE CONTRIBUTIONS TO THE PLAN. VESTING IN EMPLOYER CONTRIBUTIONS OCCURS IN ACCORDANCE WITH THE UNDERLYING PLAN DOCUMENTS. ALL ASSETS OF THE PLAN ARE HELD IN A SEPARATE TRUST. TOTAL HOSPITAL CONTRIBUTIONS TO THIS PLAN WERE AS FOLLOWS: THOMAS A. KLEINHANZL $214,627 MICHELLE K. MAHAN $23,613 JOHN R. VERBUS $26,168

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MEMBERS OR STOCKHOLDERFORM 990, PART VI, LINE 6 FREDERICK MEMORIAL HOSPITAL, INC. IS THE SOLE MEMBER OF THE CORPORATION.
POWER TO ELECT OR APPOINT MEMBERSTHE MEMBER (FMH, INC.) SHALL TAKE THE FOLLOWING ACTIONS ON BEHALF OF THE CORPORATION: -APPOINT, AND, AS NECESSARY, REMOVE THE PRESIDENT/CEO OF THE CORPORATION; PROVIDED, HOWEVER, THAT THE MEMBER SHALL TAKE NO SUCH ACTION WITHOUT PRIOR CONSULTATION WITH THE BOARD OF DIRECTORS -FORMULATE, COMMUNICATE AND IMPLEMENT STRATEGIC PLANNING AND FINANCIAL MANAGEMENT -SELECT A FISCAL AUDITOR THE CORPORATION MAY TAKE THE FOLLOWING ACTIONS ONLY WITH THE PRIOR APPROVAL OF THE MEMBER: -EXPEND OR DIVEST ITS CAPITAL ASSETS, IF THE VALUE OF SUCH EXPENDITURE OR DIVESTITURE IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -INCUR DEBT OR GUARANTEE DEBT, IF THE AGGREGATE AMOUNT OF SUCH DEBT DURING ANY TWELVE MONTH PERIOD IS IN EXCESS OF AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -EXPEND AMOUNTS IN EXCESS OF THE CORPORATION'S APPROVED ANNUAL OPERATING BUDGET IF SUCH AMOUNTS EXCEED AN AMOUNT TO BE DESIGNATED BY THE MEMBER FROM TIME TO TIME -DISSOLVE OR LIQUIDATE -CREATE, DISSOLVE OR DIVEST ANY SUBSIDIARY, PARTNERSHIP OR LLC -AMEND THE ARTICLES OF INCORPORATION AND/OR BY LAWS OF THE CORPORATION THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: -THE ADOPTION BY THE CORPORATION OF ITS ANNUAL OPERATING BUDGET OR CAPITAL BUDGET -ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS -AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION -CHANGE THE MISSION OF THE THE FOLLOWING SHALL NOT BE DEEMED TO HAVE TAKEN PLACE ABSENT SUBSEQUENT RATIFICATION BY THE MEMBER: -THE ADOPTION BY THE CORPORATION OF ITS ANNUAL OPERATING BUDGET OR CAPITAL BUDGET -ELECTION OR REPLACEMENT OF A DIRECTOR OR THE FILLING OF A VACANCY ON THE BOARD OF DIRECTORS -AT SUCH TIMES AS THE MEMBER DEEMS NECESSARY, AND PURSUANT TO THE VOTE OF AT LEAST TWO-THIRDS OF THE MEMBER'S DIRECTORS, REMOVE A DIRECTOR OF THE CORPORATION -CHANGE THE MISSION OF THE CORPORATION
DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERSFORM 990, PART VI, LINE 11B THE 990 IS PREPARED IN CONJUNCTION WITH OUTSIDE TAX ACCOUNTANTS AND IS REVIEWED BY UPPER MANAGEMENT PRIOR TO PROVIDING A COPY TO THE BOARD. A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. Form 990, Part vi, line 12c THE HOSPICE OF FREDERICK COUNTY, INC. BOARD OF DIRECTORS IS COMMITTED TO MEETING ITS FIDUCIARY RESPONSIBILITIES AND MAINTAINING ITS DUTY OF LOYALTY TO THE HOSPITAL AND THE COMMUNITY IT SERVES. TO THIS END, THE BOARD WILL EXERCISE VIGILANCE IN IDENTIFYING ANY CONFLICTS OF INTEREST. THE BOARD WILL ALSO MAINTAIN TRANSPARENCY AND OBJECTIVITY IN MAKING DECISIONS ABOUT CONFLICTS OF INTEREST SO THAT THE ORGANIZATION'S MISSION IS ALWAYS THE FIRST PRIORITY. THE CHAIRPERSON (OR VICE CHAIRPERSON IF THE CHAIR IS INVOLVED) WILL NOTIFY ALL DIRECTORS OF A REPORTED CONFLICT OF INTEREST AND WILL DECIDE WHETHER TO TAKE THE MATTER TO THE FULL BOARD TO DECIDE WHETHER A CONFLICT EXISTS AND, IF SO, TO DECIDE WHAT ACTION TO TAKE. ALTERNATIVELY, THE CHAIR PERSON WILL REFER THE MATTER TO THE GOVERNANCE COMMITTEE FOR AN IN-DEPTH EXAMINATION, SUMMARY, AND RECOMMENDATION PRIOR TO A FULL BOARD DISCUSSION AND DECISION. IF TIME IS OF THE ESSENCE, THE CHAIRPERSON WILL TAKE THE MATTER TO THE EXECUTIVE COMMITTEE, AND THE CHAIRPERSON WILL NOTIFY THE FULL BOARD OF SUCH ACTION. WHERE A CONFLICT OF INTEREST HAS BEEN IDENTIFIED THE BOARD MEMBER SHALL NOT VOTE OR BE PRESENT FOR THE DISCUSSION OR THE VOTE REGARDING THE TRANSACTION AT EITHER THE FULL BOARD, EXECUTIVE COMMITTEE, OR GOVERNANCE COMMITTEE MEETINGS EXCEPT TO ANSWER QUESTIONS THAT MAY BE ASKED OF HIM OR HER. TO PREVENT ACTUAL OR PERCEIVED INFLUENCE ON THE BOARD'S DECISION, THE CONFLICTED MEMBER IS PROHIBITED, AFTER INITIAL DISCLOSURE, FROM DISCUSSING THE CONFLICT OF INTEREST EITHER FORMALLY OR INFORMALLY WITHFELLOW DIRECTORS OR WITH MEMBERS OF THE MANAGEMENT. THERE WILL BE AN ANNUAL REVIEW OF ALL BOARD MEMBERSOFFICERS' TRANSACTIONS PREPARED BY THE ADMINISTRATION AND REVIEWED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS. AT THAT TIME, ALL DIRECTORS WILL BE REMINDED OF THE IRS INTERMEDIATE SANCTIONS REGULATION THAT ESTABLISHES EXCISE TAXES AS A SANCTION AGAINST ADMINISTRATORS AND DIRECTORS OF TAX-EXEMPT ORGANIZATIONS WHO PARTICIPATE IN 'EXCESS BENEFIT TRANSACTIONS' (E.G., UNREASONABLE HIGH EMPLOYMENT.
PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FREDERICK REGIONAL HEALTH SYSTEM, INC'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT WWW.FMH.ORG.
OTHER CHANGES IN NET ASSETSForm 990, Part Xi, line 9 GIFTS IN KIND EXPENSE -20,670 FUnDRAISER EXPENSE -28,450 Fundraiser Net Income -212,638 ---------- TOTAL -261,758

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FREDERICK MEMORIAL HOSPITAL INC
700 West Seventh StreetFREDERICKMD21701520591612HospitalMD501(c)(3)3FRHS INCfalse
FREDERICK REGIONAL HEALTH SYSTEM INC
400 WEST SEVENTH STREETFREDERICKMD21701454133096HEALTH SYSTEMMD501(c)(3)12bnafalse
MONOCACY HEALTH PARTNERS
400 WEST SEVENTH STREETFREDERICKMD21701453007639PHYS ORGMD501(c)(3)7FRHS INCYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
FREDERICK HEALTH SERVICES CORPORATION
400 WEST SEVENTH STREETFREDERICKMD21701521851661HEALTH CAREMDFRHS INCC Corp$0$00.00000Yes (true)
FREDERICK SURGICAL SERVICES CORPORATION
400 W 7TH STREETFREDERICKMD21701521642334HEALTH CAREMDFHSC INCC Corp$0$00.00000Yes (true)
Monocacy Insurance LTD
981011570Self InsuranceFRHS INCC Corp$0$00.00000Yes (true)PO BOX 1159Grand CaymanKY1-1102CYCY
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FREDERICK MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeoTransactionTypeTxt
Involved$892,432InvolvedAmt
Method Of Amount DeterminationDIRECT COSTINGMethodOfAmountDeterminationTxt

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.