ISLANDS COMMUNITY MEDICAL SERVICES INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ISLANDS COMMUNITY MEDICAL SERVICES INC (EIN 01-6012835)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-05-14
IRS object ID
201501349349301110
Schema version
2014v5.0
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

FieldValueIRS element (for citing)
Return2015-05-14T07:36:43-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010242373PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MACPAGE LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1ONE MARKET SQUAREAddressLine1Txt
CityAUGUSTACityNm
State AbbreviationMEStateAbbreviationCd
ZIP04330ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN016012835EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ISLANDS COMMUNITY MEDICAL SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlISLABusinessNameControlTxt
Phone2078634341PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line115 MEDICAL CENTER LOOPAddressLine1Txt
CityVINALHAVENCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04863ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDINAH MOYERPersonNm
Person TitleEXECUTIVE DIRECPersonTitleTxt
Phone2078634341PhoneNum
Signature2015-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT P DUBE JRPreparerPersonNm
PTINP01231018PTIN
Phone2076224766PhoneNum
Preparation2015-05-05PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

US Address USAddress

FieldValueIRS element (for citing)
Address Line115 MEDICAL CENTER LOOPAddressLine1Txt
CityVINALHAVENCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04863ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,841,067GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionTO PROVIDE MEDICAL, DENTAL, AND HEALTH AND COMMUNITY SERVICES FOR THE RESIDENTS OF VINALHAVEN, MAINE AND NEARBY ISLANDS.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee26TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$577,667PYContributionsGrantsAmt
CY Contributions Grants$824,309CYContributionsGrantsAmt
PY Program Service Revenue$964,736PYProgramServiceRevenueAmt
CY Program Service Revenue$943,846CYProgramServiceRevenueAmt
PY Investment Income$48,529PYInvestmentIncomeAmt
CY Investment Income$72,912CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,590,932PYTotalRevenueAmt
CY Total Revenue$1,841,067CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$953,327PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,069,986CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$9,261CYTotalFundraisingExpenseAmt
PY Other Expenses$631,362PYOtherExpensesAmt
CY Other Expenses$655,204CYOtherExpensesAmt
PY Total Expenses$1,584,689PYTotalExpensesAmt
CY Total Expenses$1,725,190CYTotalExpensesAmt
PY Revenues Less Expenses$6,243PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$115,877CYRevenuesLessExpensesAmt
Total Assets BOY$3,580,643TotalAssetsBOYAmt
Total Assets EOY$3,652,098TotalAssetsEOYAmt
Total Liabilities BOY$205,914TotalLiabilitiesBOYAmt
Total Liabilities EOY$128,563TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,374,729NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,523,535NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE MEDICAL, DENTAL, AND HEALTH AND COMMUNITY SERVICES FOR THE RESIDENTS OF VINALHAVEN, MAINE AND NEARBY ISLANDS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,038,199ExpenseAmt
Revenue$613,288RevenueAmt
DescTHE ORGANIZATION PROVIDED MEDICAL SERVICES TO THE COMMUNITIES OF VINALHAVEN, MATINICUS, AND NORTH HAVEN. THE ORGANIZATION OPERATES A MEDICAL CLINIC WITH TWO MEDICAL PROVIDERS AND LOCUMS TENENS COVERAGE. THE CLINIC PROVIDED COVERAGE 24 HOURS A DAY, 7 DAYS A WEEK.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$112,118ExpenseAmt
Revenue$89,629RevenueAmt
DescTHE ORGANIZATION PROVIDED DENTAL SERVICES TO THE COMMUNITIES OF VINALHAVEN, MATINICUS, AND NORTH HAVEN. THE ORGANIZATION OPERATES A DENTAL CLINIC WITH TWO DENTAL PROVIDERS WHO WORK 2.5 DAYS PER WEEK. DENTAL EMERGENCIES ARE GENERALLY HANDLED BY THE MEDICAL PROVIDERS IF THE DENTIST IS NOT AVAILABLE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$139,740ExpenseAmt
Revenue$240,929RevenueAmt
DescTHE ORGANIZATION PROVIDED BEHAVIORAL HEALTH SERVICES TO THE COMMUNITIES OF VINALHAVEN, MATINICUS, AND NORTH HAVEN. THE ORGANIZATION OPERATES THE BEHAVIORAL HEALTH CLINIC WITH ONE THERAPIST WHO WORKS 5 DAYS PER WEEK. BEHAVIORAL HEALTH EMERGENCIES ARE GENERALLY HANDLED BY THE MEDICAL PROVIDERS IF THE THERAPIST IS NOT AVAILABLE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,290,057TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee26EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DINAH B MOYERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2078634341PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line115 MEDICAL CENTER LOOPAddressLine1Txt
CityVINALHAVENCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04863ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRUCE HOPKINS
TRUSTEE0.50Yes (X)$0$0$0
BARBARA HAMILTON
TRUSTEE0.50Yes (X)$0$0$0
KAREN CANDAGE
SECRETARY1.00Yes (X)$0$0$0Yes (X)
WALTER DAY
TRUSTEE0.50Yes (X)$0$0$0
KATHI YOUNG
TRUSTEE0.50Yes (X)$0$0$0
LAURA LAZARO
TRUSTEE0.50Yes (X)$0$0$0
HUGH MARTIN
PRESIDENT2.00Yes (X)$0$0$0Yes (X)
STUART N DAMON
MED. DIRECTOR4.00Yes (X)$18,666$0$0
WYMAN PHILBROOK
TREASURER2.00Yes (X)$0$0$0Yes (X)
JON EMERSON
TRUSTEE0.50Yes (X)$0$0$0
CAROL PETILLO
TRUSTEE0.50Yes (X)$0$0$0
MERRY BOONE
TRUSTEE0.50Yes (X)$0$0$0
LAURA BLANKERTZ PHD
TRUSTEE0.50Yes (X)$0$0$0
HELEN EVARTS
TRUSTEE0.50Yes (X)$0$0$0
BARBARA K KINDER MD
VICE PRESIDENT1.00Yes (X)$0$0$0Yes (X)
WILLIAM A LIEBER MD
TRUSTEE0.50Yes (X)$0$0$0
RICHARD LITTLEFIELD
TRUSTEE0.50Yes (X)$0$0$0
RICHARD YOUNG
TRUSTEE0.50Yes (X)$0$0$0
CONNIE GEMMER
TRUSTEE1.00Yes (X)$0$0$0
DINAH MOYER
EXECUTIVE DIRECTOR40.00$67,295$0$7,275Yes (X)
JENNIFER DESMOND
NURSE PRACTITIONER36.00$142,634$0$4,386Yes (X)
ERWIN MORSE
PHYSICIAN ASSISTANT36.00$111,687$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$340,282TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$11,661TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$576,072GovernmentGrantsAmt
All Other Contributions$248,237AllOtherContributionsAmt
Total Contributions$824,309TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUDesc
Business621400BusinessCd
Total Revenue Column$943,846TotalRevenueColumnAmt
Related Or Exempt Func Income$943,846RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$943,846TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$72,912TotalRevenueColumnAmt
Exclusion$72,912ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,841,067TotalRevenueColumnAmt
Related Or Exempt Func Income$943,846RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$72,912ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$340,282TotalAmt
Program Services$271,070ProgramServicesAmt
Management And General$69,212ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$539,721TotalAmt
Program Services$419,529ProgramServicesAmt
Management And General$120,192ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$42,303TotalAmt
Program Services$30,925ProgramServicesAmt
Management And General$11,378ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$80,218TotalAmt
Program Services$62,953ProgramServicesAmt
Management And General$17,265ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$67,462TotalAmt
Program Services$52,942ProgramServicesAmt
Management And General$14,520ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$9,963TotalAmt
Management And General$9,963ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$12,590TotalAmt
Management And General$12,590ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$34,798TotalAmt
Program Services$34,378ProgramServicesAmt
Management And General$420ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$36,528TotalAmt
Program Services$31,129ProgramServicesAmt
Management And General$5,399ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$17,845TotalAmt
Program Services$7,539ProgramServicesAmt
Management And General$10,306ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MISCELLANEOUS$123,303$105,380$17,923
MEDICAL, LAB, & XRAY SU$114,537$114,537
OFFICE SUPPLIES$55,341$18,113$37,228
DISPENSARY SUPPLIES$44,194$44,194

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$206,105TotalAmt
Program Services$97,368ProgramServicesAmt
Management And General$99,476ManagementAndGeneralAmt
Fundraising$9,261FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,725,190TotalAmt
Program Services$1,290,057ProgramServicesAmt
Management And General$425,872ManagementAndGeneralAmt
Fundraising$9,261FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,943BOYAmt
EOY$26,493EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$138,056BOYAmt
EOY$178,082EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$38,108EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$219,071BOYAmt
EOY$138,140EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$35,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$28,293BOYAmt
EOY$30,080EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,487BOYAmt
EOY$2,550EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$499,846LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$347,019LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$189,355BOYAmt
EOY$152,827EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,786,571BOYAmt
EOY$1,828,396EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,214,867BOYAmt
EOY$1,222,422EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,580,643BOYAmt
EOY$3,652,098EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$121,743BOYAmt
EOY$39,491EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$45,868BOYAmt
EOY$45,051EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,303BOYAmt
EOY$44,021EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$205,914BOYAmt
EOY$128,563EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,981,034BOYAmt
EOY$2,119,850EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$178,828BOYAmt
EOY$181,263EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,214,867BOYAmt
EOY$1,222,422EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,374,729BOYAmt
EOY$3,523,535EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,580,643BOYAmt
EOY$3,652,098EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$115,877ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$25,374NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$7,555OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$187,177OtherCostOrOtherBasisAmt
Depreciation$54,184DepreciationAmt
Book Value$132,993BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$207,966OtherCostOrOtherBasisAmt
Depreciation$190,777DepreciationAmt
Book Value$17,189BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$104,703OtherCostOrOtherBasisAmt
Depreciation$102,058DepreciationAmt
Book Value$2,645BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$152,827TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST - PERP. CHAR. TRUSTDesc
Book Value$1,222,422BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,222,422TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ACCRUED EXPENSES$15,299
ACCRUED PENSION PAYABLE$28,722
FieldValueIRS element (for citing)
Total Liability$44,021TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,988,807TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$25,374NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$41,000DonatedServicesAndUseFcltsAmt
Other Revenue$7,555OtherRevenueAmt
Revenue Not Reported$73,929RevenueNotReportedAmt
Revenue Subtotal$1,914,878RevenueSubtotalAmt
Other Revenues Not Included-$73,811OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$73,811RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,841,067TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,756,929TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$41,000DonatedServicesUseFcltsAmt
Expenses Not Reported$41,000ExpensesNotReportedAmt
Expenses Subtotal$1,715,929ExpensesSubtotalAmt
Other Expenses Not Included$9,261OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$9,261ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,725,190TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, REQUIRES THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THIS GUIDANCE DOES NOT HAVE A SIGNIFICANT IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS, AS MANAGEMENT BELIEVES THAT THERE ARE NO UNCERTAIN TAX POSITIONS WITHIN ITS FINANCIAL STATEMENTS. THE ORGANIZATION HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO REVIEW OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. THE ORGANIZATION IS SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAXING AUTHORITIES FOR THE YEARS ENDED DECEMBER 31, 2011 THROUGH 2014.
PART XI, LINE 2D - OTHER ADJUSTMENTS:BENEFICIAL INTEREST IN PERPETUAL CHARITA 7,555.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FUNDRAISING EXPENSE 9,261. PRIOR YEAR WRITE OFF OF OUTSTANDING A/R -83,072.
PART XII, LINE 4B - OTHER ADJUSTMENTS:FUNDRAISING EXPENSE 9,261.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11LINE 11A EXPLANATION - THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS FOR DISCUSSION, REVIEW AND APPROVAL BEFORE FILING.
FORM 990, PART VI, SECTION C, LINE 19PRINT COPIES OF GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY COULD BE PICKED UP AT OFFICE HEADQUARTERS. FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC HOWEVER PERTINENT ANNUAL FINANCIAL RESULTS ARE REPORTED IN THE ORGANIZATION'S ANNUAL REPORT.
FORM 990, PART IX, LINE 24ECONTRACT LABOR: PROGRAM SERVICE EXPENSES 32,681. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,681. UTILITIES: PROGRAM SERVICE EXPENSES 15,249. MANAGEMENT AND GENERAL EXPENSES 6,851. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,100. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 2,494. MANAGEMENT AND GENERAL EXPENSES 18,056. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,550. STAFF DEVELOPMENT: PROGRAM SERVICE EXPENSES 14,817. MANAGEMENT AND GENERAL EXPENSES 5,542. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,359. TELEPHONE: PROGRAM SERVICE EXPENSES 9,629. MANAGEMENT AND GENERAL EXPENSES 8,547. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,176. CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 14,750. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,750. BILLING SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,218. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,218. INVESTMENT MANAGEMENT FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,122. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,122. FUNDRAISING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 9,261. TOTAL EXPENSES 9,261. POSTAGE & FREIGHT: PROGRAM SERVICE EXPENSES 2,995. MANAGEMENT AND GENERAL EXPENSES 5,051. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,046. WORKERS COMP INSURANCE: PROGRAM SERVICE EXPENSES 4,105. MANAGEMENT AND GENERAL EXPENSES 3,561. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,666. BANK CHARGES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 7,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,275. CONTRACTED PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 6,573. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,573. LOCUMS TENENS: PROGRAM SERVICE EXPENSES 5,978. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,978. EQUIPMENT LEASE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,568. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,568. ADVERTISING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,935. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,935. LICENSES & PERMITS: PROGRAM SERVICE EXPENSES 1,740. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,740. FACILITY COSTS: PROGRAM SERVICE EXPENSES 1,107. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,107.
FORM 990, PART XI, LINE 9:BENEFICIAL INTEREST IN PERPETUAL CHARITABLE TRUST 7,555.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS NOT CHANGED THE COMMITTEE'S OVERSIGHT OR SELECTION PROCESS.

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