BUCKSPORT REGIONAL HEALTH CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- BUCKSPORT REGIONAL HEALTH CENTER (EIN 23-7335894)
- Tax period
- 2017-04-01 to 2018-03-31
- Filed
- 2018-08-15
- IRS object ID
- 201842279349301959
- 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 | 2018-08-15T12:17:03-04:00 | ReturnTs |
| Tax Period End | 2018-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010411241 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESTER M KEARNEY PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1550 | AddressLine1Txt |
| City | PRESQUE ISLE | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04769 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237335894 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BUCKSPORT REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BUCK | BusinessNameControlTxt |
| Phone | 2074692366 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 BROADWAY | AddressLine1Txt |
| City | BUCKSPORT | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04416 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAROL M CAREW | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 2074692366 | PhoneNum |
| Signature | 2018-08-09 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TIMOTHY P POITRAS | PreparerPersonNm |
| PTIN | P00542788 | PTIN |
| Phone | 2077643171 | PhoneNum |
| Preparation | 2018-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANN REMICK | PrincipalOfficerNm |
| Gross Receipts | $7,198,397 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BUCKSPORTRHC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | BUCKSPORT REGIONAL HEALTH CENTER'S MISSION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH AND COMMUNITY SERVICES IN THE BUCKSPORT, MAINE AREA. IT IS A FEDERALLY QUALIFIED HEALTH CENER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 85 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,197,240 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,355,208 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,480,483 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,789,007 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,808 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,801 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,047 | PYOtherRevenueAmt |
| CY Other Revenue | $36,016 | CYOtherRevenueAmt |
| PY Total Revenue | $6,700,578 | PYTotalRevenueAmt |
| CY Total Revenue | $7,197,032 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,418,893 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,634,399 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,097,401 | PYOtherExpensesAmt |
| CY Other Expenses | $2,352,872 | CYOtherExpensesAmt |
| PY Total Expenses | $6,516,294 | PYTotalExpensesAmt |
| CY Total Expenses | $6,987,271 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $184,284 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $209,761 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,651,004 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,808,510 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,713,251 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,653,092 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,937,753 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,155,418 | NetAssetsOrFundBalancesEOYAmt |
| Mission | BUCKSPORT REGIONAL HEALTH CENTER'S MISSION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH AND COMMUNITY SERVICES IN THE BUCKSPORT, MAINE AREA. IT IS A FEDERALLY QUALIFIED HEALTH CENER. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,812,464 | ExpenseAmt |
| Revenue | $4,789,007 | RevenueAmt |
| Desc | THE CENTER PROVIDES OUTPATIENT MEDICAL, BEHAVIORAL HEALTH AND DENTAL CARE SERVICES TO BUCKSPORT AND SURROUNDING AREA POPULATION. | Desc |
| Total Program Service Expenses | $5,812,464 | 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 | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | 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 | false | 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 | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 85 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 |
| States Where Copy Of Return Is Fld | ME | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN ENGLAND | PersonNm |
| Phone | 2074697371 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 BROADWAY | AddressLine1Txt |
| City | BUCKSPORT | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04416 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ANN REMICK | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONALD HOUGHTON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL ORMSBY | |||||||
| VICE PRESIDE | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GERALD COUTURE | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GARY MURRAY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RHONDA VARNEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VALERIE SULYA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HEATHER BRAY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA VINON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROL M CAREW | |||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $150,819 | $0 | $8,593 | ||
| SUSAN ENGLAND | |||||||
| CHIEF FINANC | 40.00 | Yes (X) | $87,579 | $0 | $1,276 | ||
| JACKIE HUNT | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HANS L DUVELFELT | |||||||
| MD | 40.00 | $323,074 | $0 | $9,465 | Yes (X) | ||
| BETH ANN LIBERMAN MD | |||||||
| MD | 40.00 | $206,088 | $0 | $1,276 | Yes (X) | ||
| TIMOTHY S CLIFFORD JR | |||||||
| MD | 40.00 | $156,197 | $0 | $1,057 | Yes (X) | ||
| CINDY AVERY | |||||||
| MD | 40.00 | $136,674 | $0 | $13,909 | Yes (X) | ||
| JOHN C BJORN MD | |||||||
| MD | 40.00 | $127,843 | $0 | $276 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,188,274 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $35,852 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AROOSTOOK MENTAL HEALTH CENTER | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1018 | AddressLine1Txt |
| City | CARIBOU | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04736 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CONTRACT SERV. | ServicesDesc |
| Compensation | $168,270 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,121,200 | GovernmentGrantsAmt |
| All Other Contributions | $234,008 | AllOtherContributionsAmt |
| Total Contributions | $2,355,208 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Total Revenue Column | $4,789,007 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,789,007 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,789,007 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,166 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,166 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,365 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,365 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,365 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$1,365 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Total Revenue Column | $36,016 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,016 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $36,016 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,197,032 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,841,824 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,794,645 | TotalAmt |
| Program Services | $3,005,541 | ProgramServicesAmt |
| Management And General | $789,104 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,419 | TotalAmt |
| Program Services | $392,445 | ProgramServicesAmt |
| Management And General | $159,974 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,335 | TotalAmt |
| Program Services | $212,744 | ProgramServicesAmt |
| Management And General | $74,591 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $710,197 | TotalAmt |
| Program Services | $652,969 | ProgramServicesAmt |
| Management And General | $57,228 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,413 | TotalAmt |
| Program Services | $230,693 | ProgramServicesAmt |
| Management And General | $10,720 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,527 | TotalAmt |
| Program Services | $122 | ProgramServicesAmt |
| Management And General | $2,405 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,384 | TotalAmt |
| Program Services | $76,154 | ProgramServicesAmt |
| Management And General | $30,230 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,343 | TotalAmt |
| Program Services | $258,158 | ProgramServicesAmt |
| Management And General | $185 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,459 | TotalAmt |
| Program Services | $41,257 | ProgramServicesAmt |
| Management And General | $17,202 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $700,009 | $694,910 | $5,099 |
| DUES & PUBLICATIONS | $82,222 | $78,521 | $3,701 |
| EDUCATION | $62,322 | $49,903 | $12,419 |
| RECRUITING | $53,034 | $53,034 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,962 | TotalAmt |
| Program Services | $66,013 | ProgramServicesAmt |
| Management And General | $11,949 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,987,271 | TotalAmt |
| Program Services | $5,812,464 | ProgramServicesAmt |
| Management And General | $1,174,807 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,933 | BOYAmt |
| EOY | $381,155 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,109,559 | BOYAmt |
| EOY | $1,330,209 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $543,835 | BOYAmt |
| EOY | $610,664 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,681 | BOYAmt |
| EOY | $38,199 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,761,811 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,591,257 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,388,171 | BOYAmt |
| EOY | $4,170,554 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,825 | BOYAmt |
| EOY | $277,729 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,651,004 | BOYAmt |
| EOY | $6,808,510 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,566 | BOYAmt |
| EOY | $312,337 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,714 | BOYAmt |
| EOY | $75,913 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,389,971 | BOYAmt |
| EOY | $2,264,842 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,713,251 | BOYAmt |
| EOY | $2,653,092 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,587,266 | BOYAmt |
| EOY | $3,817,435 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,487 | BOYAmt |
| EOY | $337,983 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,937,753 | BOYAmt |
| EOY | $4,155,418 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,651,004 | BOYAmt |
| EOY | $6,808,510 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $209,761 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $7,904 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,432,774 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,717,317 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,044,498 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,197,240 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,355,208 | CurrentTaxYearAmt |
| Total | $9,747,037 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,432,774 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,717,317 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,044,498 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,197,240 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,355,208 | CurrentTaxYearAmt |
| Total | $9,747,037 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $9,747,037 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $30,704 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,825 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,490 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,808 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,801 | CurrentTaxYearAmt |
| Total | $94,628 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,780 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,579 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,231 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,047 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,016 | CurrentTaxYearAmt |
| Total | $56,653 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,898,318 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,843,189 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98470 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98530 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME 56,653 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $269,825 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $20,693 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $12,789 | OtherExpendituresAmt |
| End Year Balance | $277,729 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $262,102 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $20,722 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $12,999 | OtherExpendituresAmt |
| End Year Balance | $269,825 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $277,697 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$2,931 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $12,664 | OtherExpendituresAmt |
| End Year Balance | $262,102 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $282,529 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $10,152 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $14,984 | OtherExpendituresAmt |
| End Year Balance | $277,697 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $267,612 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $26,038 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $11,121 | OtherExpendituresAmt |
| End Year Balance | $282,529 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $126,145 | OtherCostOrOtherBasisAmt |
| Book Value | $126,145 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,635,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,591,257 | DepreciationAmt |
| Book Value | $4,044,409 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,170,554 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $7,197,032 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $7,197,032 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,197,032 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,987,271 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $6,987,271 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $6,987,271 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 2, PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | TO PURCHASE MEDICAL EQUIPMENT TO BE USED IN CONJUCTION WITH THE ORGANIZATION'S MISSION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| CAROL M CAREW | ||||
| EXECUTIVE DIRECTOR | $150,819 | $1,276 | $7,317 | $159,412 |
| HANS L DUVELFELT | ||||
| MD | $323,074 | $1,276 | $8,189 | $332,539 |
| BETH ANN LIBERMAN MD | ||||
| MD | $206,088 | $1,276 | $207,364 | |
| TIMOTHY S CLIFFORD JR | ||||
| MD | $156,197 | $276 | $781 | $157,254 |
| CINDY AVERY | ||||
| MD | $136,674 | $1,000 | $12,909 | $150,583 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED AND APPROVED BY BOARD PRIOR TO SUBMISSION |
| FORM 990, PAGE 6, PART VI, LINE 12C | PART VI, SECTION B - POLICIES ITEM 12C DOES THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WTH A CONFLICT OF INTEREST POLICY? THE BOARD OF DIRECTORS EACH HAS THEIR PERSONAL COPY OF THE BY-LAWS OF THE HEATLH CENTER WHICH SPECIFIES IN ARTICLE VI, SECTION 5 THAT "MEMBERS OF THE BOARD SHALL EXCLUDE THEMSELVES FROM VOTING ON ANY ISSUE, MOTION, OR RESOLUTION WHICH MAY DIRECTLY OR INDIRECTLY INURE TO THEIR BENFIT." CONFLICT OF INTEREST MAY BE RAISED BY ANY BOARD MEMBER AT ANY BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ITEMS 15A AND 15B-THE BOARD DETERMINES THE COMPENSATION FOR THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION FOR ALL OTHER EMPLOYEES INCLUDING KEY EMPLOYEES. THE DECISIONS USE THE MANAGMENT COMPENSATION SURVEY ISSUED ANNUALLY BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION FOR THE EXECUTIVE DIREDTOR'S COMPENSATION COMPARABILITY. THE KEY EMPLOYEES' COMPENSATION IS DETERMINED USING THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY ISSUED ANNUALLY BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION. THE BOARD ANNUALLY APPOINTS A COMMITTEE OF THE BOARD TO REVIEW AND EVALUATE THE EXECUTIVE DIRECTOR. THE COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD FOR ITS CONSIDERATION. THE BOARD DELEGATGES ALL PERSONNEL MATTERS TO THE EXECUTIVE DIRECTOR. ANNUAL REVIEWS ARE CONDUCTED. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED USING THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY. |
| FORM 990, PAGE 6, PART VI, LINE 15B | ITEMS 15A AND 15B-THE BOARD DELEGATES ALL PERSONNEL MATTERS TO THE EXECUTIVE DIRECTOR. ANNUAL REVIEWS ARE CONDUCTED. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED USING THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY. OFFICERS ARE NOT COMPENSATED. |
| FORM 990, PAGE 6, PART VI, LINE 19 | A COPY OF THE BY-LAWS AND RECENT AUDITED FINANCIAL STATEMENTS IS AVAILABLE ON REQUEST FOR PUBLIC REVIEW DURING REGULAR BUSINESS HOURS |
| FORM 990, PART IX, LINE 11G | CONSULTANTS 6,032 22,099 0 COMPUTER NETWORK SERVICE 233,674 4,748 0 OUTSIDE SERVICES 413,263 30,381 0 TOTAL 652,969 57,228 0 |
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