SEACOAST AFFILIATED GROUP PRACTICE INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SEACOAST AFFILIATED GROUP PRACTICE INC (EIN 04-3485648)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-08-03
- IRS object ID
- 201612169349301171
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-03T13:05:06-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135381590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 PORTLAND STREET | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02114 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043485648 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEACOAST AFFILIATED GROUP PRACTICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SEAC | BusinessNameControlTxt |
| Phone | 9784631000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN KILDAY | PersonNm |
| Person Title | VP/CFO | PersonTitleTxt |
| Phone | 9784631000 | PhoneNum |
| Signature | 2016-08-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY T ROGERS | PreparerPersonNm |
| PTIN | P01074284 | PTIN |
| Phone | 6177427788 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN KILDAY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,801,852 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AJH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | SAGP IS A MULTI-SPECIALTY MEDICAL GROUP PRACTICE THAT PROVIDES PROFESSIONAL MEDICAL CARE IN THE COMMUNITY SERVED BY ANNA JAQUS HOSPITAL. PHYSICIANS TREAT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND ADHERE TO THE HOSPITAL'S CHARITY CARE POLICY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 173 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $305,879 | PYContributionsGrantsAmt |
| CY Contributions Grants | $150,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,384,319 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,615,450 | CYProgramServiceRevenueAmt |
| PY Investment Income | $190 | PYInvestmentIncomeAmt |
| CY Investment Income | $94 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,384 | PYOtherRevenueAmt |
| CY Other Revenue | $36,308 | CYOtherRevenueAmt |
| PY Total Revenue | $16,709,772 | PYTotalRevenueAmt |
| CY Total Revenue | $16,801,852 | 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 | $14,234,469 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,465,856 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,257,894 | PYOtherExpensesAmt |
| CY Other Expenses | $3,888,301 | CYOtherExpensesAmt |
| PY Total Expenses | $17,492,363 | PYTotalExpensesAmt |
| CY Total Expenses | $18,354,157 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$782,591 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,552,305 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,769,444 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,268,591 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,447,469 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,498,923 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $321,975 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,230,332 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SAGP IS A MULTI-SPECIALTY MEDICAL GROUP PRACTICE THAT PROVIDES PROFESSIONAL MEDICAL CARE IN THE COMMUNITY SERVED BY ANNA JAQUS HOSPITAL. PHYSICIANS TREAT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND ADHERE TO THE HOSPITAL'S CHARITY CARE POLICY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,149,775 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $5,629,301 | RevenueAmt |
| Desc | WOMEN'S HEALTH CARE IS THE LARGEST OF THE SAGP PRACTICES, SERVING THE WOMEN OF GREATER NEWBURYPORT, THE CITY WHERE AJH IS LOCATED. DURING FISCAL YEAR 2015, THE PHYSICIANS, NURSES, AND MIDWIVES ASSISTED AT 720 DELIVERIES, AS WELL AS PERFORMING SURGERY AND SEEING PATIENTS FOR OFFICE VISITS. THEY OFFER CHILDBIRTH CLASSES AND BREASTFEEDING CLASSES TO THEIR PATIENTS. THERE ARE NO OTHER OBSTETRIC PRACTICES IN THE SERVICE AREA, SO WOMEN'S HEALTH CARE IS CENTRAL TO THE SUCCESS OF ANNA JAQUES HOSPITAL. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,083,936 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,389,680 | RevenueAmt |
| Desc | NORTH SHORE INTERNAL MEDICINE IS A LARGE PRIMARY CARE PRACTICE BASED IN NEWBURYPORT, THE CITY WHERE AJH IS LOCATED. THE PHYSICIANS AND NURSE PRACTITIONERS FROM NSIM SAW THEIR PATIENTS FOR A TOTAL OF 32,055 VISITS IN FISCAL 2015, INCLUDING VISITS WITH 652 NEW PATIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,040,062 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,331,533 | RevenueAmt |
| Desc | THE HOSPITALIST PROGRAM EMPLOYS PHYSICIANS WHO CARE FOR ANNA JAQUES HOSPITAL INPATIENTS. DURING FISCAL 2015, THESE DOCTORS CARED FOR 3228 PATIENTS, OR 71 PERCENT OF ALL HOSPITAL MEDICAL/SURGICAL INPATIENTS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,972,983 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $5,295,512 | RevenueAmt |
| Desc | PRACTICE REVENUE PROGRAM EXPENSEATLANTIC SURGICAL ASSOC $1,237,030 $1,210,816COASTAL MEDICAL ASSOC 1,444,750 1,560,781BREAST CARE CENTER 425,227 774,187NE ENDOCRINOLOGY 635,839 726,645NEWBORN CARE 365,016 578,589GI ASSOCIATES 346,134 522,392SLOCUM FAMILY PRACTICE 342,731 394,944HIGHLAND PRIMARY CARE 143,060 163,278COASTAL EXTENDED CARE/OTHER 355,725 1,041,351 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $6,972,983 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $5,295,512 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $17,246,756 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 173 | 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 | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9784631000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 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 |
|---|---|---|---|---|---|---|---|---|
| DAVID LAFLAMME | ||||||||
| DIRECTOR | 5.00 | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| ANN LAGASSE | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK GOLDSTEIN | ||||||||
| PRESIDENT/CEO | 5.00 | 55.00 | Yes (X) | $0 | $544,922 | $126,200 | Yes (X) | |
| KEVIN KILDAY | ||||||||
| VP/CFO | 5.00 | 55.00 | Yes (X) | $0 | $92,574 | $10,063 | Yes (X) | |
| DELIA O'CONNOR | ||||||||
| PRES/CEO THRU 12/31/14 | 5.00 | 55.00 | Yes (X) | $0 | $761,064 | $47,484 | Yes (X) | |
| SAIRA NASEER-GHIASUDDIN | ||||||||
| PHYSICIAN | 50.00 | 10.00 | $904,437 | $0 | $35,360 | Yes (X) | ||
| DAVID SWIERZEWSKI | ||||||||
| PHYSICIAN | 50.00 | 5.00 | $758,423 | $50,000 | $25,820 | Yes (X) | ||
| KIMBERLY KERSTEN | ||||||||
| PHYSICIAN | 50.00 | $454,039 | $0 | $15,957 | Yes (X) | |||
| PETER HARTMANN | ||||||||
| PHYSICIAN | 50.00 | $379,428 | $0 | $28,678 | Yes (X) | |||
| KAY FICHT | ||||||||
| PHYSICIAN | 50.00 | $319,547 | $0 | $33,535 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,815,874 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,448,560 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $323,097 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | 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 |
|---|---|---|---|---|---|
| MEDICUS HOSPITALISTS LLC | |||||
| 22 ROULSTON RD | WINDHAM | NH | 03087 | LOCUM PHYSICIAN COVERAGE | $147,911 |
| NEWBURYPORT GASTROENTEROLOGY LLC | |||||
| 255 LOW ST SUITE 201 | NEWBURYPORT | MA | 01950 | OVERHEAD FOR EMPLOYED PHYSICIAN | $107,086 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $150,000 | RelatedOrganizationsAmt |
| Total Contributions | $150,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $16,615,450 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,615,450 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,615,450 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $94 | TotalRevenueColumnAmt |
| Exclusion | $94 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,732 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,732 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,732 | TotalRevenueColumnAmt |
| Exclusion | $5,732 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PHYSICIAN DIRECTOR FEE | 621110 | $18,408 | $18,408 |
| BILLING FEES | 621110 | $11,008 | $11,008 |
| REBATES/DISCOUNTS | 621110 | $1,160 | $1,160 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $30,576 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,801,852 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,646,026 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,826 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,417,297 | TotalAmt |
| Program Services | $11,720,606 | ProgramServicesAmt |
| Management And General | $696,691 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,778 | TotalAmt |
| Program Services | $152,817 | ProgramServicesAmt |
| Management And General | $8,961 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,192,914 | TotalAmt |
| Program Services | $1,127,015 | ProgramServicesAmt |
| Management And General | $65,899 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $693,867 | TotalAmt |
| Program Services | $655,333 | ProgramServicesAmt |
| Management And General | $38,534 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,000 | TotalAmt |
| Management And General | $33,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,011,888 | TotalAmt |
| Program Services | $895,028 | ProgramServicesAmt |
| Management And General | $116,860 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,930 | TotalAmt |
| Program Services | $11,930 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $475,358 | TotalAmt |
| Program Services | $475,358 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $821,027 | TotalAmt |
| Program Services | $821,027 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,791 | TotalAmt |
| Program Services | $1,415 | ProgramServicesAmt |
| Management And General | $68,376 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,069 | TotalAmt |
| Program Services | $6,069 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,545 | TotalAmt |
| Program Services | $127,545 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $697,306 | TotalAmt |
| Program Services | $697,306 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| UTILITIES | $284,350 | $284,350 | $0 | $0 |
| DUES | $256,500 | $256,500 | $0 | $0 |
| RECRUITING | $50,000 | $0 | $50,000 | $0 |
| COLLECTIONS | $29,080 | $0 | $29,080 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,457 | TotalAmt |
| Program Services | $14,457 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,354,157 | TotalAmt |
| Program Services | $17,246,756 | ProgramServicesAmt |
| Management And General | $1,107,401 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,393 | BOYAmt |
| EOY | $481,774 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,050,401 | BOYAmt |
| EOY | $2,424,395 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $516,697 | BOYAmt |
| EOY | $790,012 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,678,878 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,106,470 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $699,953 | BOYAmt |
| EOY | $572,408 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,769,444 | BOYAmt |
| EOY | $4,268,591 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,546,875 | BOYAmt |
| EOY | $1,818,634 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,900,594 | BOYAmt |
| EOY | $3,680,289 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,447,469 | BOYAmt |
| EOY | $5,498,923 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $321,975 | BOYAmt |
| EOY | -$1,230,332 | 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 | $321,975 | BOYAmt |
| EOY | -$1,230,332 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,769,444 | BOYAmt |
| EOY | $4,268,591 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,552,305 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $112,850 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $305,879 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $150,000 | CurrentTaxYearAmt |
| Total | $568,729 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,842,872 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,253,315 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,467,386 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,397,288 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,646,025 | CurrentTaxYearAmt |
| Total | $75,606,886 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,842,872 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,253,315 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,580,236 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,703,167 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,796,025 | CurrentTaxYearAmt |
| Total | $76,175,615 | 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 | $76,175,615 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,457 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,876 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,045 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,826 | CurrentTaxYearAmt |
| Total | $32,809 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,457 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,876 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,045 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,826 | CurrentTaxYearAmt |
| Total | $32,809 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,850,329 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,260,191 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,586,281 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,709,772 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,801,851 | CurrentTaxYearAmt |
| Total | $76,208,424 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99960 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99950 | PublicSupportPY509Pct |
| Investment Income CY | 0.00040 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00050 | 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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $460,818 | OtherCostOrOtherBasisAmt |
| Depreciation | $349,958 | DepreciationAmt |
| Book Value | $110,860 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,218,060 | OtherCostOrOtherBasisAmt |
| Depreciation | $756,512 | DepreciationAmt |
| Book Value | $461,548 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $572,408 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $3,657,001 |
| DEFERRED RENT | $23,288 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,680,289 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THERE IS NO FIN 48(ASC 740) FOOTNOTE IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK GOLDSTEIN | ||||||||||||||
| PRESIDENT/CEO | $0 | $462,706 | $0 | $82,216 | $0 | $0 | $0 | $98,627 | $0 | $27,573 | $0 | $671,122 | $0 | $0 |
| DELIA O'CONNOR | ||||||||||||||
| PRES/CEO THRU 12/31/14 | $0 | $628,907 | $0 | $132,157 | $0 | $0 | $0 | $29,075 | $0 | $18,409 | $0 | $808,548 | $0 | $0 |
| SAIRA NASEER-GHIASUDDIN | ||||||||||||||
| PHYSICIAN | $450,056 | $0 | $454,381 | $0 | $0 | $0 | $7,800 | $0 | $27,560 | $0 | $939,797 | $0 | $0 | $0 |
| DAVID SWIERZEWSKI | ||||||||||||||
| PHYSICIAN | $541,992 | $50,000 | $216,431 | $0 | $0 | $0 | $7,800 | $0 | $18,020 | $0 | $784,243 | $50,000 | $0 | $0 |
| KIMBERLY KERSTEN | ||||||||||||||
| PHYSICIAN | $354,860 | $0 | $99,179 | $0 | $0 | $0 | $7,800 | $0 | $8,157 | $0 | $469,996 | $0 | $0 | $0 |
| PETER HARTMANN | ||||||||||||||
| PHYSICIAN | $379,428 | $0 | $0 | $0 | $0 | $0 | $3,625 | $0 | $25,053 | $0 | $408,106 | $0 | $0 | $0 |
| KAY FICHT | ||||||||||||||
| PHYSICIAN | $319,547 | $0 | $0 | $0 | $0 | $0 | $5,975 | $0 | $27,560 | $0 | $353,082 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR THE CEO AND CFO IS NOT SET BY THE SAGP BOARD, BUT BY THE BOARD OF THE PARENT, SRHS. THE SRHS BOARD DOES UTILIZE A COMPENSATION COMMITTEE, INDEPENDENT CONSULTANT, AND COMPENSATION STUDIES/SURVEYS TO SET THE EXECUTIVES' SALARIES. THE EXECUTIVE COMMITTEE OF THE SRHS BOARD APPROVES PAYMENTS BEFORE THEY ARE MADE. |
| PART I, LINE 4B | DELIA O'CONNOR, CEO THROUGH 12/31/14, PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. SHE IS 100% VESTED IN THIS PLAN AND IS ENTITLED TO RECEIVE DISTRIBUTIONS UPON THE TERMINATION OF HER EMPLOYMENT. NO EMPLOYER CONTRIBUTION WAS MADE TO THIS PLAN IN CY 2014. IN ADDITION, MS. O'CONNOR AND MARK GOLDSTEIN PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FUNDED BY A SPLIT DOLLAR LIFE INSURANCE POLICY. NO PREMIUM PAYMENT WAS MADE FOR MS. O'CONNOR'S POLICY IN CY 2014. MR. GOLDSTEIN'S PREMIUM WAS $70,560. |
| PART I, LINE 5 | DRS. SAIRA NASEER-GHIASUDDIN AND KIMBERLY KERSTEN WERE PAID BONUSES BASED ON THE PERFORMANCE OF NORTH SHORE INTERNAL MEDICINE, A DIVISION OF SAGP. THE AMOUNTS WERE $454,381 AND $99,179 RESPECTIVELY. DR. DAVID SWIERZEWSKI WAS PAID A BONUS OF $216,431 BASED ON THE PERFORMANCE OF ATLANTIC SURGICAL ASSOCIATES, A DIVISION OF SAGP. |
| PART I, LINE 6 | DELIA O'CONNOR'S AND MARK GOLDSTEIN'S BONUS PAYMENTS WERE CONTINGENT ON THE ORGANIZATIONS WITHIN THE SYSTEM MEETING SEVERAL TARGETS, INCLUDING THE TARGETED EARNINGS OF THE ORGANIZATIONS. THE AMOUNTS PAID WERE $132,157 AND $82,216 RESPECTIVELY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SEACOAST REGIONAL HEALTH SYSTEMS, INC (SRHS), THE PARENT OF THE SYSTEM, IS THE SOLE MEMBER OF SAGP. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SRHS BOARD ELECTS THE MEMBERS OF THE SAGP BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | APPROVAL BY THE STHS BOARD IS REQUIRED FOR THE ADOPTION OF ANNUAL OPERATING AND CAPITAL BUDGETS; FOR THE MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANY OTHER CORPORATION; AND FOR THE DECISION TO CONDUCT ANY FUND-RAISING ACTIVITIES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY STAFF, REVIEWED BY AN OUTSIDE ACCOUNTING FIRM AND BY THE CEO AND CFO. ONCE APPROVED, A COPY OF THE 990 IS AVAILABLE TO THE BOARD FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF TRUSTEES AND THE SENIOR EXECUTIVES REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY AND COMPLETE A SURVEY ABOUT POSSIBLE CONFLICTS OF INTEREST. THEIR ANSWERS ARE REVIEWED BY THE CHAIRPERSON TO DETERMINE IF CONFLICTS EXIST. IF THERE IS A CONFLICT OF INTEREST ON A PARTICULAR ISSUE, THE CHAIRPERSON REQUESTS THAT THE BOARD MEMBER ABSTAIN FROM VOTING AT THAT TIME. THE CHAIRPERSON OR SECRETARY MONITORS SURVEYS TO ENSURE COMPLIANCE. |
| FORM 990, PART VI, SECTION B, LINE 15 | TOTAL COMPENSATION FOR THE SENIOR EXECUTIVE TEAM IS REVIEWED ANNUALLY BY AN INDEPENDENT COMMITTEE OF THE SRHS BOARD (THE PARENT). THE COMMITTEE USES DATA RECEIVED FROM AN INDEPENDENT COMPENSATION CONSULTING FIRM TO DETERMINE FAIRNESS AND COMPARABILITY OF THE SALARIES, AND DECIDES WHETHER ANY CHANGES ARE TO BE MADE. IN ADDITION, THE COMMITTEE AGREES ON BENCHMARKS FOR EXECUTIVE BONUSES AT THE START OF EACH YEAR, AND REVIEWS PROGRESS AT THE CONCLUSION OF THE YEAR TO DETERMINE WHAT BONUSES ARE PAYABLE. BONUSES ARE INCLUDED IN TOTAL COMPENSATION DURING THE REVIEW PROCESS MENTIONED ABOVE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ANNA JAQUES HOSPITAL | |||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01950 | 042104338 | HOSPITAL | MA | 501(C)(3) | LINE 3 | 0 |
| SEACOAST REGIONAL HEALTH SYSTEMS | |||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01950 | 222814214 | FUNCTIONALLY INTEGRATED SUPPORTING ORG | MA | 501(C)(3) | LINE 11B, II | 0 |
| ANNA JAQUES COMMUNITY HEALTH FOUNDATION | |||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01950 | 043318952 | FUNDRAISING ORGANIZATION | MA | 501(C)(3) | LINE 11A, I | 0 |
| SEACOAST REGIONAL MRI | |||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01950 | 320443663 | PHYSICIAN PRACTICES | MA | 501(C)(3) | LINE 9 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER NEWBURYPORT MANAGEMENT SERVICES ORG | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161744477 | EIN |
| Primary Activities | MANAGEMENT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ANNA JAQUES HOSPITAL | ||
| C | $150,000 | FMV |
| ANNA JAQUES HOSPITAL | ||
| J | $3,600 | FMV |
| ANNA JAQUES HOSPITAL | ||
| K | $147,217 | FMV |
Comments