ADVANCE COMMUNITY HEALTH INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ADVANCE COMMUNITY HEALTH INC (EIN 56-1004791)
- Tax period
- 2014-12-01 to 2015-11-30
- Filed
- 2016-10-17
- IRS object ID
- 201622919349300517
- Schema version
- 2014v6.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule M
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-10-17T09:13:58-05:00 | ReturnTs |
| Tax Period End | 2015-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561004791 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAKE HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % PENELLA WASHINGTON | InCareOfNm |
| Business Name Control | WAKE | BusinessNameControlTxt |
| Phone | 9192502923 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 ROCK QUARRY RD | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PENELLA WASHINGTON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9192502923 | PhoneNum |
| Signature | 2016-10-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANCE COMMUNITY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PENELLA WASHINGTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 ROCK QUARRY RD | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,765,624 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ADVANCECHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | WHSI DBA ADVANCE COMMUNITY HEALTH PROVIDES QUALITY HEALTH CARE IN SIX LOCATIONS TO THE RESIDENTS OF WAKE AND FRANKLIN COUNTIES, NC. SEE SCH O FOR ADDITIONAL DETAILS | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 193 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,161,496 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,905,757 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,774,417 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,859,867 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$4,119 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $9,931,794 | PYTotalRevenueAmt |
| CY Total Revenue | $10,765,624 | 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 | $7,836,692 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,230,845 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $17,636 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,193,121 | PYOtherExpensesAmt |
| CY Other Expenses | $3,766,098 | CYOtherExpensesAmt |
| PY Total Expenses | $11,029,813 | PYTotalExpensesAmt |
| CY Total Expenses | $11,996,943 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,098,019 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,231,319 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,097,167 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,270,962 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,040,463 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,516,733 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,056,704 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$245,771 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO DELIVER QUALITY, COMPASSIONATE PRIMARY HEALTH CARE - EVERY PATIENT, EVERY TIME - IN RESPONSE TO NEEDS OF OUR COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,931,868 | ExpenseAmt |
| Revenue | $3,868,965 | RevenueAmt |
| Desc | FAMILY MEDICINE: DURING FY2015, FAMILY MEDICINE SERVICES WERE PROVIDED RESULTING IN 30,425 ENCOUNTERS. THESE SERVICES INCLUDED PREVENTATIVE, ACUTE AND CHRONIC CARE SERVICES AS WELL AS DIABETIC CARE AND EDUCATION, NUTRITION COUNSELING, ASTHMA CARE, WOMEN'S HEALTH, WEIGHT MANAGEMENT AND HYPERTENSION. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,559,010 | ExpenseAmt |
| Revenue | $2,291,196 | RevenueAmt |
| Desc | PEDIATRICS: THE PEDIATRIC PRACTICE PROVIDES A FULL RANGE OF PRIMARY MEDICAL SERVICES TO ITS PATIENTS. EMPHASIS WAS PLACED ON WELL CHILD CARE, IMMUNIZATIONS, ASTHMA CARE AND PREVENTION AND WEIGHT MANAGEMENT/NUTRITION COUNSELING. SERVICES PROVIDED RESULTED IN 9,509 PEDIATRIC ENCOUNTERS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $637,095 | ExpenseAmt |
| Revenue | $651,688 | RevenueAmt |
| Desc | DENTISTRY: THE DENTAL PROGRAM EXPANDED CONSIDERABLY IN NOVEMBER 2015. THE DENTAL PROGRAM RELOCATED AND MOVED INTO A STATE OF THE ART 10 OPERATORY SPACE. SERVICES HISTORICALLY INCLUDED ORAL HYGIENE, RESTORATIVE SERVICES AND EXTRACTIONS. WITH THE RELOCATION THE FIRST INITIATIVE WAS TO PARTNER WITH THE PEDIATRICS PROGRAM TO ENSURE SCHOOL AGED CHILDREN AND BABIES FROM THE FIRST TOOTH ARE RECEIVING APPROPRIATE DENTAL CARE. IN ADDITION, AN INITIATIVE TO FULLY INTEGRATE ORAL HEALTH SERVICES WITH ADVANCE'S MEDICAL PROGRAM BEGAN. IN 2015, THE DENTAL STAFF PROVIDED 3,894 VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $367,267 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $48,018 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $7,495,240 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | false | 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 | 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 | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 193 | 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 | false | QuidProQuoContributionsInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PENELLA WASHINGTON | PersonNm |
| Phone | 9192502923 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 ROCK QUARRY ROAD | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAMES R ALLEN | ||||||||
| BOARD MEMBER | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ELAINE BROWN | ||||||||
| CHAIRPERSON | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DARRELL GRIER | ||||||||
| BOARD MEMBER ENDING 06/2015 | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| TARA MINTER | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DESIREE PETERSON | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JAMES W TEAGLE | ||||||||
| TREASURER | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARQUETTE DAVIS RUSSELL | ||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ACIE WARD | ||||||||
| VICE CHAIR | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| HAROLD R HICKS | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| HERMAN P WILKINS | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CARLA MENA | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| RAJ BAHADUR | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT H TOLER | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LAINI JARRETT | ||||||||
| BOARD MEMBER BEGINNING 8/2015 | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| PENELLA WASHINGTON | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 0.25 | $158,829 | $0 | $13,446 | Yes (X) | ||
| CHARLES FAUST | ||||||||
| CHIEF OPERATING OFFICER | 40.0 | 0.25 | $116,289 | $0 | $11,626 | Yes (X) | ||
| NICOLE BLAKE | ||||||||
| HUMAN RESOURCES EXECUTIVE | 40.0 | 0.0 | $40,942 | $0 | $2,603 | Yes (X) | ||
| JACK JUSTICE | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.25 | $2,115 | $0 | $115 | Yes (X) | ||
| DAVID GOFF | ||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | $184,077 | $0 | $13,480 | Yes (X) | ||
| DORIS BATTS-MURRAY | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $132,676 | $0 | $13,822 | Yes (X) | ||
| SHELLY RICKERT | ||||||||
| DENTIST | 40.0 | 0.0 | $135,625 | $0 | $12,302 | Yes (X) | ||
| FARAZ AKHTAR | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $167,033 | $0 | $2,769 | Yes (X) | ||
| RADHA GUDDATI | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $115,087 | $0 | $12,890 | Yes (X) | ||
| JILL WRIGHT | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $140,214 | $0 | $6,447 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,192,887 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $89,500 | 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 (2 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| BKD LLP | |
| AUDIT/TAX/COST RPT | $130,752 |
| TINKBIRD HEALTHCARE STAFFING | |
| STAFFING | $136,060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,751,819 | GovernmentGrantsAmt |
| All Other Contributions | $153,938 | AllOtherContributionsAmt |
| Noncash Contributions | $90,770 | NoncashContributionsAmt |
| Total Contributions | $3,905,757 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $6,738,821 | $6,738,821 |
| EHR INCENTIVE REVENUE | 624100 | $121,046 | $121,046 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,859,867 | 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 |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 | $10,765,624 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,859,867 | RelatedOrExemptFuncIncomeAmt |
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 | $543,523 | TotalAmt |
| Program Services | $436,764 | ProgramServicesAmt |
| Management And General | $106,759 | 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 | $6,558,010 | TotalAmt |
| Program Services | $4,024,084 | ProgramServicesAmt |
| Management And General | $2,533,926 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,761 | TotalAmt |
| Program Services | $52,255 | ProgramServicesAmt |
| Management And General | $36,506 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $456,208 | TotalAmt |
| Program Services | $287,868 | ProgramServicesAmt |
| Management And General | $168,340 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $584,343 | TotalAmt |
| Program Services | $372,670 | ProgramServicesAmt |
| Management And General | $211,673 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $18,333 | TotalAmt |
| Management And General | $18,333 | ManagementAndGeneralAmt |
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 | $458,321 | TotalAmt |
| Program Services | $146,436 | ProgramServicesAmt |
| Management And General | $311,885 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,996 | TotalAmt |
| Program Services | $8,324 | ProgramServicesAmt |
| Management And General | $5,672 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555,218 | TotalAmt |
| Program Services | $279,742 | ProgramServicesAmt |
| Management And General | $257,840 | ManagementAndGeneralAmt |
| Fundraising | $17,636 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,679 | TotalAmt |
| Management And General | $127,679 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $692,545 | TotalAmt |
| Program Services | $405,968 | ProgramServicesAmt |
| Management And General | $286,577 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,136 | TotalAmt |
| Program Services | $2,739 | ProgramServicesAmt |
| Management And General | $26,397 | 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 | $71,541 | TotalAmt |
| Management And General | $71,541 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,859 | TotalAmt |
| Program Services | $14,191 | ProgramServicesAmt |
| Management And General | $9,668 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,840 | TotalAmt |
| Program Services | $152,165 | ProgramServicesAmt |
| Management And General | $103,675 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,301 | TotalAmt |
| Program Services | $32,296 | ProgramServicesAmt |
| Management And General | $22,005 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $788,445 | $788,445 | |
| MEDICAL SUPPLIES & DRUGS | $491,293 | $491,293 | |
| RECRUITING & RETENTION | $144,660 | $144,660 | |
| LICENSES, DUES, SUBSCRIPTION | $40,931 | $40,931 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,996,943 | TotalAmt |
| Program Services | $7,495,240 | ProgramServicesAmt |
| Management And General | $4,484,067 | ManagementAndGeneralAmt |
| Fundraising | $17,636 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,131 | BOYAmt |
| EOY | $177,866 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,880 | BOYAmt |
| EOY | $41,507 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,000 | BOYAmt |
| EOY | $267,728 | 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 | $58,154 | BOYAmt |
| EOY | $100,814 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,421 | BOYAmt |
| EOY | $192,083 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,921,674 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,477,894 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,105,299 | BOYAmt |
| EOY | $443,780 | 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 | $5,100 | 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 | $1,261,282 | BOYAmt |
| EOY | $1,042,084 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,097,167 | BOYAmt |
| EOY | $2,270,962 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,015,345 | BOYAmt |
| EOY | $1,167,599 | 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 | $0 | 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 | $1,025,118 | BOYAmt |
| EOY | $1,349,134 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,040,463 | BOYAmt |
| EOY | $2,516,733 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,056,704 | BOYAmt |
| EOY | -$245,771 | 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 | $3,056,704 | BOYAmt |
| EOY | -$245,771 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,097,167 | BOYAmt |
| EOY | $2,270,962 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,231,319 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$37,027 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$2,034,129 | OtherChangesInNetAssetsAmt |
| 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,118,660 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,710,872 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,938,438 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,161,496 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,905,757 | CurrentTaxYearAmt |
| Total | $17,835,223 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,552,170 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,857,936 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,783,388 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,774,417 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,859,867 | CurrentTaxYearAmt |
| Total | $34,827,778 | 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 | $11,670,830 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,568,808 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,721,826 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,935,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,765,624 | CurrentTaxYearAmt |
| Total | $52,663,001 | 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 | $52,663,001 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $243 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $77 | CurrentTaxYearMinus3YearsAmt |
| Total | $320 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $243 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $77 | CurrentTaxYearMinus3YearsAmt |
| Total | $320 | 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 | $11,671,073 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,568,885 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,721,826 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,935,913 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,765,624 | CurrentTaxYearAmt |
| Total | $52,663,321 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99999 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99999 | PublicSupportPY509Pct |
| Investment Income CY | 0.00001 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00001 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Form4720 Filed | false | Form4720FiledInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, QUESTION 1I | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE NORTH CAROLINA COMMUNITY HEALTH CENTER ASSOCIATION. A PORTION OF THE DUES MAY BE ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $172,821 | OtherCostOrOtherBasisAmt |
| Depreciation | $81,738 | DepreciationAmt |
| Book Value | $91,083 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,748,853 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,396,156 | DepreciationAmt |
| Book Value | $352,697 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $443,780 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EST AMT DUE FROM THIRD PTY PYR | $1,037,310 |
| OTHER ASSETS | $4,774 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,042,084 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $9,977,179 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$788,445 | OtherRevenueAmt |
| Revenue Not Reported | -$788,445 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,765,624 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $10,765,624 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,208,498 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $11,208,498 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $788,445 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $788,445 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,996,943 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, QUESTION 2 | UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ ( 788,445) BAD DEBT EXPENSE |
| SCHEDULE D, PART XII, QUESTION 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 788,445 BAD DEBT EXPENSE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PENELLA WASHINGTON | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $158,829 | $0 | $0 | $0 | $0 | $0 | $6,353 | $0 | $7,093 | $0 | $172,275 | $0 | $0 | $0 |
| DAVID GOFF | ||||||||||||||
| CHIEF MEDICAL OFFICER | $184,077 | $0 | $0 | $0 | $0 | $0 | $7,363 | $0 | $6,117 | $0 | $197,557 | $0 | $0 | $0 |
| FARAZ AKHTAR | ||||||||||||||
| PHYSICIAN | $167,033 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,769 | $0 | $169,802 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp | |
| Drugs And Medical Supplies | DrugsAndMedicalSuppliesGrp | |
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | DENTAL EQUIPMENT | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $90,770 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule N IRS990ScheduleN
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liquidation Of Assets Table | LiquidationOfAssetsTableGrp |
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | FIXED ASSETS | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2014-12-01 | DistributionDt |
| Fair Market Value Of Asset | $2,034,129 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BOOK VALUE | MethodOfFMVDeterminationTxt |
| EIN | 471270222 | EIN |
| Person | EMERALD QUARRY | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 ROCK QUARRY ROAD | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (true) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | false | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | false | OwnerOfSuccessor2Ind |
| Receive Compensation2 | false | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE N, PART II, LINE 2E | FormAndLineReferenceDesc |
| Explanation | DIRECTOR OR TRUSTEE OF TRANSFEREE ORGANIZATION: PENELLA WASHINGTON, CEO OF WAKE HEALTH SERVICES, INC., SERVES AS A TRUSTEE FOR EMERALD QUARRY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION: Wake Health Services d/b/a Advance Community Health is a private, not for profit, federally qualified health center (FQHC) operating 4 practice sites and 1 outreach site in Wake and Franklin Counties. Founded in 1972, Advance provides primary care, dental, mental health and other wrap around services to all ages from newborns to senior citizens. Advance serves patients that are publicly insured (Medicare and Medicaid), commercially Insured (including persons insured through the Marketplace Exchange), Underinsured, Uninsured and Homeless populations. The staff of approximately 130 employees includes Board Certified Internists, Family Physicians, Pediatricians, Adolescent Care Specialist, Infectious Disease Physician, Physician Assistants, Family Nurse Practitioners, Registered Nurses, Licensed Clinical Social Workers, Licensed Clinical Addiction Specialist, Registered Dieticians, Case Managers, Bilingual Staff and other Clinical and Administrative Support Staff. Advance Community Health provides referrals to specialists, discounted fees, and assistance with prescriptions. In 2015, the organization served 17,879 unduplicated patients of which 1,115 were homeless and one-third were children. Approximately 90% of patients are under 200% of the Federal Poverty Level. Approximately 25% of patients are uninsured, 40% Medicaid/NC Health Choice; 21% Medicare and 14% have commercial insurance. Advance Community Health partners with local hospitals, public health, social services and community agencies to meet the needs of the communities we serve. Advance has four specialized programs on the Southeast Raleigh campus including Adolescent Health Program, CAPUS Clinic, Horizon Healthcare for the Homeless and Advance/Rex Senior Health Center. Our wraparound services include After Hours Coverage; Health Insurance Enrollment; Medicaid Eligibility Assistance; Medicare Enrollment Assistance; and Voter Registration. |
| FORM 990, PART III, LINE 4D | DESCRIPTION OF OTHER PROGRAM SERVICES: HEALTHCARE FOR THE HOMELESS: THE HORIZON HEALTHCARE FOR THE HOMELESS PROGRAM PROVIDED A FULL RANGE OF PRIMARY CARE, MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AT THE SOUTHEAST RALEIGH MEDICAL PRACTICE AND AT THE SOUTH WILMINGTON 300 BED MEN'S SHELTER IN RALEIGH. THE HEALTHCARE FOR THE HOMELESS PROGRAM PARTNERS WITH OTHER COMMUNITY AGENCIES TO ASSIST PATIENTS WITH OTHER ENABLING SERVICES INCLUDING HOUSING, FOOD AND CLOTHING. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: ARTICLE V. STANDING COMMITTEES Section 1. Creation. The Board of Trustees shall, at the last meeting of the calendar year or at such other time as the Board shall determine, designate the following committees with responsibilities as hereinafter designated. Board committees may be augmented with advisory members, as set forth below. Advisory members are community members and business experts who volunteer to assist the Corporation's Standing Committees. Advisory members shall not serve as Trustees and shall have no voting authority on behalf of the full governing board or otherwise serve as fiduciaries and policy makers on behalf of the Corporation. Advisory members cannot serve as Chair of a Standing Committee or serve on the Executive Committee. Executive Committee: The minimum number of Trustees constituting the Executive Committee shall be five (5). The Trustees constituting the Executive Committee shall be the officers of the Corporation and the Chairpersons of the other Standing Committees. The immediate past Chairperson of the Corporation shall be a member of the Executive Committee; or has the option to serve on the Executive Committee, if they are a member of the Board of Trustees. The officers of the Corporation shall serve in those capacities on the Executive Committee. The Executive Committee shall have and may exercise all of the authority of the Board of Trustees in the management of the Corporation during the interim periods between meetings of the Board of Trustees, except as otherwise provided by law or by resolution of the Board of Trustees. When the Executive Committee takes any action on behalf of the Board between regular Board meetings, that business shall be reported and ratified at the next Board meeting. The Executive Committee shall also have the responsibility for: - working with the CEO in providing leadership in the development of the organization's long and short range plans - leading the Board in an annual review of mission and vision - reviewing and making decisions on sensitive human resources and legal matters - conducting the preliminary annual review of the CEO's performance. The final review of the CEO's performance shall be approved by the full Board of Trustees. Budget and Finance Committee: The minimum number of Trustees and advisory members constituting the Budget and Finance Committee shall be three (3), at least two (2) of whom must be Trustees. The Committee shall have the responsibility for: - overseeing the financial operations of the Corporation - overseeing the preparation of the annual budget and monitoring budget variances with actual revenue and expenditures - reviewing the Corporation's monthly financial statements - reviewing and recommending the financial and investment policies of the Corporation. The Committee shall make recommendations to the Board of Trustees for their approval. Business Strategies Committee: The minimum number of Trustees and advisory members constituting the Business Strategies Committee shall be three (3). The Committee shall have the responsibility for: - reviewing and recommending changes to hours of operation and locations - reviewing and recommending confidentiality policies to ensure the protection of proprietary and other corporate information - reviewing the Corporation's HIPAA, HITECH and corporate compliance adherence - evaluating operational activities including service utilization patterns, productivity, patient access and achievement of program objectives - overseeing organization's compliance with HRSA's 19 program requirements - reviewing and recommending human resources policies - evaluating and providing oversight with compensation and benefit plans The Committee shall make recommendations to the Board of Trustees for their approval. Fundraising Committee: The minimum number of Trustees and advisory members constituting the Fundraising Committee shall be three (3). The Committee shall have the responsibility for: - overseeing the activities of the Corporation relative to fundraising and grant development - spearheading the Corporation's capital campaign - recommending long-term fundraising strategies The Committee shall make recommendations to the Board of Trustees for their approval. Healthcare Quality and Risk Management Committee: The minimum number of Trustees and advisory members constituting the Healthcare Quality and Risk Management Committee shall be three (3). The Committee shall have the responsibility for: - reviewing and recommending improvements to the delivery of healthcare services - reviewing and recommending clinical policies - reviewing and monitoring the healthcare quality and risk management plans - reviewing and monitoring the healthcare quality indicators from HRSA and internal quality metrics - reviewing and recommending risk assessment and risk management policies - monitoring and recommending areas of focus based on quality of care indicators, health disparity data, and needs assessment data - reviewing and recommending the scope of services provided by the Corporation - reviewing and recommending the credentials of the licensed clinical staff - reviewing compliance with OSHA, CLIA, NCQA and other regulatory agency guidelines and requirements related to clinical operations - evaluating the success of programs in relation to the healthcare plan and community needs. The Committee shall make recommendations to the Board of Trustees for their approval. Marketing & Communications Committee: The minimum number of Trustees and advisory members constituting the Marketing & Communications Committee shall be three (3). The Committee shall have the responsibility for: - overseeing activities relative to branding - overseeing activities relative to informing the general public about services offered by the Corporation - overseeing activities related to government and public affairs - communicating the mission and vision of the organization - supporting advocacy and outreach activities to build visibility and support - advising and overseeing branding initiatives and managing the brand identity - reviewing and recommending the marketing and public relations plans. The Committee shall make recommendations to the Board of Trustees for their approval. Membership/Bylaws Committee: The minimum number of Trustees constituting the Membership/Bylaws Committee shall be three (3). Advisory members are prohibited from serving on the Membership/Bylaws Committee. The Committee shall have the responsibility for: - recommending a slate of officers at the first Board meeting of the calendar year, or at such other time as the Board shall determine - making recommendations to the Board throughout the year for Board members and officers to fill expiring terms and seats vacated by resignations or otherwise - coordinating the interview process for new Board candidates - coordinating the orientation of new Board members - monitoring the Board's compliance with the Bylaws and Board Governance Policies of the Corporation - making recommendations, as appropriate, for revisions to the Bylaws and Board Governance Policies - overseeing the annual board self-evaluation process and board training needs. The Committee shall make recommendations to the Board of Trustees for their approval. Audit Committee. The Audit Committee shall consist of at least three members, none of whom shall be members of the Corporation's management team, and at least two members being current Trustees. The Committee shall have responsibility for: - reviewing the proposed scope of the annual audit - recommending a firm of independent auditors to the Board to conduct the annual audit - receiving the results and recommendations of the independent auditors on completion of the annual audit - receiving and reviewing reports from the Chief Financial Officer indicating the progress being made toward the accomplishment of any recommendations made by the independent auditors - reviewing the system of internal controls and the performance of the Corporation's internal audit services and monitoring compliance by management with certain policies of the Corporation. The Committee shall make recommendations to the Budget and Finance Committee and to the Board of Trustees for their approval. |
| FORM 990 PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS FOR REVIEW PRIOR TO THE RETURN BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS INCLUDED IN ITS STANDARD OF CONDUCTS POLICY AND GOVERNING BYLAWS. THE PROCESS OF MONITORING COMPLIANCE WITH THIS POLICY INCLUDES PROVIDING CONFLICT OF INTEREST DISCLOSURE STATEMENTS TO EVERY EMPLOYEE, BOARD MEMBER, CONSULTANT, AND VOLUNTEER. THE DISCLOSURE STATEMENT IS REQUIRED TO BE UPDATED ANNUALLY AT THE BEGINNING OF THE YEAR. THE FOLLOWING DESCRIBES FOR THE DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AMONG DIFFERENT POSITIONS WITHIN THE ORGANIZATION. - MEMBERS OF, AND CANDIDATES FOR MEMBERSHIP ON, THE BOARD OF TRUSTEES MUST MAKE DISCLOSURES TO THE CHAIR OF THE BOARD OF TRUSTEES. IF THE CHAIR HAS AN INTEREST TO DISCLOSE, HE OR SHE MUST MAKE DISCLOSURE TO THE VICE CHAIR, RESPECTIVELY, WHO WILL, IN TURN BE RESPONSIBLE FOR ADVISING THE BOARD. - THE CEO MUST MAKE DISCLOSURES TO THE CHAIR OF THE BOARD WHO WILL, IN TURN, BE RESPONSIBLE FOR ADVISING THE BOARD OF SUCH DISCLOSURE. - STAFF ENGAGED IN THE AWARD OR ADMINISTRATION OF CONTRACTS MUST MAKE DISCLOSURES IN WRITING TO THE CEO. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED WITH A BOARD MEMBER, THE BOARD MEMBER MAY MAKE A PRESENTATION TO THE BOARD REGARDING WHETHER OR NOT HE OR SHE HAS A CONFLICT OF INTEREST, AND MAY RESPOND TO RELATED QUESTIONS FROM THE BOARD. HOWEVER, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTING ON, WHETHER THE CONFLICT OF INTEREST EXISTS. IF SUCH CONFLICT IS DETERMINED TO EXIST, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTING ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED WITH A PERSON WHO IS NOT A BOARD MEMBER, THE CEO SHALL MAKE THE DETERMINATION. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | EXECUTIVE COMPENSATION REVIEW: THE COMPENSATION OF THE ORGANIZATION'S CEO, OTHER OFFICERS, AND KEY EMPLOYEES WAS COMPILED BY THE HR EXECUTIVE USING NATIONAL AND LOCAL DATA FOR SALARY AND BENEFIT COMPARISON. THE HR COMMITTEE OF THE BOARD THEN REVIEWS THE SALARIES AND PROVIDES TO THE BOARD FOR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC FOR INSPECTION UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $ ( 2,034,129) TRANSFERS TO AFFILIATE |
| FORM 990, PART XII, LINE 2C | COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDIT: THE ORGANIZATION AMENDED ITS BYLAWS DURING FISCAL YEAR 2015 TO INCLUDE A CHANGE TO THE COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT. PLEASE SEE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION A, LINE 4. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMERALD QUARRY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 ROCK QUARRY RD | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471270222 | EIN |
| Primary Activities | OWN FACILITY | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 11A1 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHSI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| 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 | false | 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 | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMERALD QUARRY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $2,034,129 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |