Your Health Network Inc: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- Your Health Network Inc (EIN 46-1962771)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201633209349313333
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T17:19:38-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 202153727 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SB & COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 INTERNATIONAL CIRCLE SUITE 5500 | AddressLine1Txt |
| City | HUNT VALLEY | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21030 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461962771 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YOUR HEALTH NETWORK INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | YOUR | BusinessNameControlTxt |
| Phone | 4434750990 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 FALLS ROAD SUITE 1 | AddressLine1Txt |
| City | BALTIMORE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21211 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER L BEILENSON | PersonNm |
| Person Title | MD MPH CHAIRMAN OF THE BOARD | PersonTitleTxt |
| Phone | 4434750990 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHEILA EICHELBERGER | PreparerPersonNm |
| PTIN | P00743897 | PTIN |
| Phone | 4105840060 | PhoneNum |
| Preparation | 2016-11-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVERGREEN HEALTH CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ELIZABETH BURGER MUNFA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 FALLS ROAD SUITE 1 | AddressLine1Txt |
| City | BALTIMORE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,381,443 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | EVERGREENMD.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PATIENT-CENTERED HIGH QUALITY HEALTH AND WELLNESS SERVICES THAT DEEPLY ENGAGE AND EMPOWER MARYLANDERS TO BE STEWARDS OF THEIR OWN HEALTH, WITH THE DESIRED IMPACT OF HEALTHIER COMMUNITIES AND THE REDUCTION OF HEALTH DISPARITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 27 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $441,875 | PYContributionsGrantsAmt |
| CY Contributions Grants | $79,375 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $537,264 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,237,075 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $200 | CYInvestmentIncomeAmt |
| PY Other Revenue | $893 | PYOtherRevenueAmt |
| CY Other Revenue | $64,793 | CYOtherRevenueAmt |
| PY Total Revenue | $980,032 | PYTotalRevenueAmt |
| CY Total Revenue | $2,381,443 | 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 | $2,396,692 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,485,247 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,650,574 | PYOtherExpensesAmt |
| CY Other Expenses | $1,985,289 | CYOtherExpensesAmt |
| PY Total Expenses | $4,047,266 | PYTotalExpensesAmt |
| CY Total Expenses | $3,470,536 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,067,234 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,089,093 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,055,084 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,256,950 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,234,922 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,525,881 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,179,838 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$5,268,931 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE PATIENT-CENTERED HIGH QUALITY HEALTH AND WELLNESS SERVICES THAT DEEPLY ENGAGE AND EMPOWER MARYLANDERS TO BE STEWARDS OF THEIR OWN HEALTH, WITH THE DESIRED IMPACT OF HEALTHIER COMMUNITIES AND THE REDUCTION OF HEALTH DISPARITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,141,410 | ExpenseAmt |
| Revenue | $2,237,075 | RevenueAmt |
| Desc | IN THE 2015 TAX YEAR, THE STAFF OF THE ORGANIZATION CONDUCTED THE FOLLOWING CORE ACTIVITIES - PROVISION OF PATIENT CARE, WITH EXTREMELY POSITIVE INITIAL PATIENT FEEDBACK AND CLINICAL OUTCOMES THAT SUGGEST THAT THIS MODEL IS, INDEED, OUTPERFORMING PEER HEALTH CARE PROVIDERS. FOR EXAMPLE, INITIAL DATA SUGGESTS THAT THE ORGANIZATION HAS BEEN ABLE TO REDUCE UNNECESSARY EMERGENCY ROOM (ER) UTILIZATION RELATIVE TO OTHER COMMERCIALLY INSURED INDIVIDUALS - OUTREACH TO COMMUNITIES TO RAISE AWARENESS ABOUT THE NEW OFFERING-COLLABORATION WITH PUBLIC HEALTH OFFICIALS AND OTHER NON-PROFITS TO INFORM PLANS AND LAY THE GROUNDWORK FOR COLLABORATION-CONTRACTING WITH MEDICAID MANAGED CARE ORGANIZATIONS(MCOS) TO PROVIDE MEDICAL CARE TO MEDICAID PARTICIPANTS, INCLUDING THOSE WHO BENEFITED FROM MARYLAND'S EXPANSION OF THE MEDICAID PROGRAM-CONTRACTING WITH THE MARYLAND'S VETERAN'S ADMINISTRATION(VA) TO PROVIDE PRIMARY CARE SERVICES TO VETERANS WHO WOULD OTHERWISE EXPERIENCE LONG WAIT TIMES TO GET AN APPOINTMENT AT A VA FACILITY (BY TAKING ON THESE PATIENTS (AND DOING SO QUICKLY), WE ARE CERTAINLY PROVIDING A PUBLIC SERVICE TO OUR COUNTRY'S VETERANS, THUS RELIEVING FEDERAL BURDEN IN A WAY THAT HAS NO PRIVATE INTEREST AND IS CONSISTENT WITH OUR DESIRE TO SERVE INDIVIDUALS REGARDLESS OF ECONOMIC STRATA OR TYPE OF INSURANCE COVERAGE)-DEVELOPMENT OF PARTNERSHIP WITH THE HOWARD COUNTY LOCAL HEALTH IMPROVEMENT COALITIONS(LHICS) TO IMPROVE ACCESS TO HIGH QUALITY PRIMARY CARE FOR VULNERABLE HOWARD COUNTY RESIDENTS-EXPANSION OF OUR HEALTH COACHING PROGRAM TO INCLUDE FREE CRISIS INTERVENTION SERVICES FOR PATIENTS-ONGOING DEVELOPMENT/EXPANSION OF OUR MENTAL HEALTH SERVICES TO PROVIDE MORE INTENSIVE SERVICES(I.E. PSYCHOTHERAPY) TO PATIENTS WHOSE MENTAL HEALTH NEEDS EXTEND BEYOND THE INITIAL SCOPE OF SERVICES-OUTREACH TO PATIENTS WHO ARE NOT ACTIVELY ACCESSING PRIMARY CARE MEDICAL CARE SERVICES TO ENCOURAGE THEM TO SCHEDULE PREVENTIVE OFFICE VISITS-PARTICIPATION IN A GRANT PROGRAM BY THE HORIZON FOUNDATION THAT ENABLE US TO FUND A HEALTH COACH POSITION. THE HEALTH COACH PROVIDED FREE PREVENTIVE HEALTH COACHING AND BEHAVIORAL HEALTH SUPPORT TO PATIENTS OF THE HOWARD COUNTY-BASED OFFICE-EARLY PLANNING FOR SEVERAL INITIATIVES THAT WILL BE IMPLEMENTED IN 2015/16, INCLUDING BUT NOT LIMITED TO-GROUP HEALTH SUPPORT AND DISEASE EDUCATION ON HEALTH TOPICS SUCH AS SMOKING CESSATION, DIABETES MANAGEMENT, STRESS AND ANXIETY MANAGEMENT, PARENTING-MEDICATION ASSISTANCE PROGRAM TO HELP LOW-INCOME COMMERCIALLY INSURED PATIENTS WITH CHRONIC DISEASES AFFORD MEDICATION WHERE A FINANCIAL BARRIER(E.G.CO-INSURANCE, PRE-DEDUCTIBLE OUT OF POCKET REQUIREMENT) WOULD OTHERWISE PREVENT FILLING OF A PRESCRIPTION-PARTNERSHIP WITH PSYCHIATRISTS TO INCREASE ACCESS TO PSYCHIATRY FOR OUR PATIENTS VIA TELE-CONSULTATION. | Desc |
| Total Program Service Expenses | $2,141,410 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 27 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELIZABETH MUNFA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4434513873 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 FALLS ROAD SUITE 1 | AddressLine1Txt |
| City | BALTIMORE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21211 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PETER L BEILENSON MD MPH | ||||||||
| DIRECTOR, PRESIDENT, CHAIRMAN | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICK BARTH PHD | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| SETH BENSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GAIL DOERR | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| NEAL FRIEDLANDER MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JIM MCGILL PHD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WHITNEY REID | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| LEN SHERMAN | ||||||||
| TREASURER, SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT CLARK ESQ | ||||||||
| GENERAL COUNSEL | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH BURGER | ||||||||
| EXECUTIVE DIRECTOR | 2.00 | Yes (X) | $108,102 | $0 | $16,000 | |||
| JOY BALDWIN ASTLE | ||||||||
| PHYSICIAN | 40.00 | $150,246 | $0 | $16,609 | Yes (X) | |||
| MELISSA AVIVA CLARK | ||||||||
| PHYSICIAN | 40.00 | $111,964 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $370,312 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $32,609 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SHR & ASSOCIATES | |||||
| 130 ADMIRAL COCHRANE DRIVE SUITE 1 | ANNAPOLIS | MD | 21401 | MANAGEMENT AND BILLING SERVICES | $172,869 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | PROVIDE DOCTORS WHO WORK AS TEMPORARY EM | $108,427 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $79,375 | AllOtherContributionsAmt |
| Total Contributions | $79,375 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,237,075 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,237,075 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,237,075 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $200 | TotalRevenueColumnAmt |
| Exclusion | $200 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MICELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $64,793 | TotalRevenueColumnAmt |
| Exclusion | $64,793 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $64,793 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,381,443 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,237,075 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $64,993 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,957 | TotalAmt |
| Management And General | $290,957 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $938,842 | TotalAmt |
| Program Services | $938,842 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,001 | TotalAmt |
| Program Services | $33,001 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,481 | TotalAmt |
| Program Services | $135,481 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,966 | TotalAmt |
| Program Services | $73,921 | ProgramServicesAmt |
| Management And General | $13,045 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,303 | TotalAmt |
| Program Services | $64,751 | ProgramServicesAmt |
| Management And General | $183,552 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,628 | TotalAmt |
| Management And General | $14,628 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,950 | TotalAmt |
| Management And General | $51,950 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $437,681 | TotalAmt |
| Program Services | $175,500 | ProgramServicesAmt |
| Management And General | $262,181 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,408 | TotalAmt |
| Program Services | $4,408 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120 | TotalAmt |
| Management And General | $120 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $514,386 | TotalAmt |
| Program Services | $514,386 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,317 | TotalAmt |
| Program Services | $6,317 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,158 | TotalAmt |
| Program Services | $4,158 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,756 | TotalAmt |
| Management And General | $211,756 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,807 | TotalAmt |
| Management And General | $107,807 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,920 | TotalAmt |
| Program Services | $77,727 | ProgramServicesAmt |
| Management And General | $3,193 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| LOAN ACQUISITION COSTS | $123,831 | $123,831 | |
| CLINICAL SUPPLIES | $112,918 | $112,918 | |
| HR/PAYROLL | $2,931 | $2,931 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,175 | TotalAmt |
| Management And General | $63,175 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,470,536 | TotalAmt |
| Program Services | $2,141,410 | ProgramServicesAmt |
| Management And General | $1,329,126 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $699,297 | BOYAmt |
| EOY | $90,061 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $200,578 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,925 | BOYAmt |
| EOY | $23,321 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,537 | BOYAmt |
| EOY | $64,909 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,381 | BOYAmt |
| EOY | $42,002 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $890,208 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $221,339 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $764,254 | BOYAmt |
| EOY | $668,869 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $43,500 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,690 | BOYAmt |
| EOY | $123,710 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,055,084 | BOYAmt |
| EOY | $1,256,950 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $326,197 | BOYAmt |
| EOY | $231,783 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,908,725 | BOYAmt |
| EOY | $6,294,098 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,234,922 | BOYAmt |
| EOY | $6,525,881 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,432,806 | BOYAmt |
| EOY | -$5,277,056 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $252,968 | BOYAmt |
| EOY | $8,125 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,179,838 | BOYAmt |
| EOY | -$5,268,931 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,055,084 | BOYAmt |
| EOY | $1,256,950 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,089,093 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $75,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $441,875 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $79,375 | CurrentTaxYearAmt |
| Total | $596,250 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $537,264 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,237,075 | CurrentTaxYearAmt |
| Total | $2,774,339 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $75,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $979,139 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,316,450 | CurrentTaxYearAmt |
| Total | $3,370,589 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $75,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $235,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,500 | CurrentTaxYearAmt |
| Total | $362,500 | 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) |
|---|---|---|
| Current Tax Year Minus2 Years | $75,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $235,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,500 | CurrentTaxYearAmt |
| Total | $362,500 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,008,089 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $200 | CurrentTaxYearAmt |
| Total | $200 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $200 | CurrentTaxYearAmt |
| Total | $200 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $893 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $64,793 | CurrentTaxYearAmt |
| Total | $65,686 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $75,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $980,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,381,443 | CurrentTaxYearAmt |
| Total | $3,436,475 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $447,043 | OtherCostOrOtherBasisAmt |
| Depreciation | $92,071 | DepreciationAmt |
| Book Value | $354,972 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,484 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,736 | DepreciationAmt |
| Book Value | $54,748 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $368,681 | OtherCostOrOtherBasisAmt |
| Depreciation | $109,532 | DepreciationAmt |
| Book Value | $259,149 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $668,869 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEPOSITS | Desc |
| Book Value | $123,710 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $123,710 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| LINE OF CREDIT | $6,050,000 |
| DEFERRED RENT | $196,320 |
| DUE TO EVERGREEN HEALTH CARE | $47,778 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,294,098 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,384,571 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $3,128 | OtherRevenueAmt |
| Revenue Not Reported | $3,128 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,381,443 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,381,443 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,473,664 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $3,128 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $3,128 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,470,536 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,470,536 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE COMPANY IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND IS RECOGNIZED AS SUCH BY THE INTERNAL REVENUE SERVICE. ACCOUNTING PRINCIPLES ACCEPTED IN THE UNITED STATES OF AMERICA PROVIDES CONSISTENT GUIDANCE FOR THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBE A THRESHOLD OF "MORE LIKELY THAN NOT" FOR RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE COMPANY PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2015, AND DETERMINED THAT THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE ACCOMPANYING FINANCIAL STATEMENTS OR WHICH MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS. AS OF DECEMBER 31, 2015, THE STATUTE OF LIMITATIONS FOR FISCAL YEAR 2013, THE YEAR OF INCEPTION, THROUGH 2015 REMAINS OPEN WITH THE U.S. FEDERAL JURISDICTION AND THE VARIOUS STATES AND LOCAL JURISDICTIONS IN WHICH THE COMPANY FILES TAX RETURNS. IT IS THE COMPANY'S POLICY TO RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IF ANY, IN INCOME TAX EXPENSE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | ALLOWANCE FOR BAD DEBT 3,128. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | ALLOWANCE FOR BAD DEBTS 3,128. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOY BALDWIN ASTLE | PersonNm |
| Title | PHYSICIAN | TitleTxt |
| Base Compensation Filing Org | $150,246 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $16,609 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $166,855 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER L BEILENSON | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | THE OFFICER LISTED IS ALSO OFFICER OF EVERGREEN HEALTH COOPERATIVE, INC. | RelationshipDescriptionTxt |
| Transaction | $253,035 | TransactionAmt |
| Transaction | YHN AND EVERGREEN HAVE AN ADMINISTRATIVE SERVICES AGREEMENT WHERE EVERGREEN PERFORMS CERTAIN SERVICES ON BEHALF OF YHN. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO CORPORATE MANAGEMENT SUPPORT, ACCOUNTING AND FINANCE, OCCUPANCY, INFORMATION TECHNOLOGY CONSULTING AND SUPPORT, DATA COLLECTION AND REPORTING, HUMAN RESOURCES, AND MARKETING AND LEGAL SERVICES. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED BY THE CEO BY THE CEO AND THE COO. THE FORM IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT IF AN INTERESTED PERSON HAS AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE PERSON MUST DISCLOSE THE EXTENSION AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15A | IN 2015, THE COMPENSATION OF THE EXECUTIVE DIRECTOR WAS DETERMINED BY THE INDEPENDENT BOARD OF DIRECTORS. MARKET SURVEYS WERE USED TO DETERMINE REASONABLE COMPENSATION. THE APPROVAL OF THE EMPLOYMENT CONTRACT WAS DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS, CONFLICT OF INTERESTS POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
| FORM 990, PART IX, LINE 11G | OTHERE PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 175,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,500. LAB : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 90,484. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,484. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 171,697. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 171,697. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
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