Northeast Iowa Medical Education: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- Northeast Iowa Medical Education (EIN 42-1058745)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2015-11-12
- IRS object ID
- 201503169349303335
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-12T13:08:05-06:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1545 ASSOCIATES DR STE 101 | AddressLine1Txt |
| City | DUBUQUE | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52002 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421058745 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northeast Iowa Medical Education Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 3192722525 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 Kimball Avenue No 101 | AddressLine1Txt |
| City | Waterloo | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50702 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Anthony A Day | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 3192722525 | PhoneNum |
| Signature | 2015-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Carmen Krantz | PreparerPersonNm |
| PTIN | P00031958 | PTIN |
| Phone | 5635561790 | PhoneNum |
| Preparation | 2015-11-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Anthony A Day | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 Kimball Avenue No 101 | AddressLine1Txt |
| City | Waterloo | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50702 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,144,828 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.familypracticeresidency.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | Developing family medicine physicians through modeling and teaching | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 96 | TotalEmployeeCnt |
| Total Volunteers | 79 | TotalVolunteersCnt |
| Total Gross UBI | -$2,097 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,476,368 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,081,916 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,114,627 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,048,292 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,389 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,083 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,195 | PYOtherRevenueAmt |
| CY Other Revenue | $4,440 | CYOtherRevenueAmt |
| PY Total Revenue | $7,610,579 | PYTotalRevenueAmt |
| CY Total Revenue | $7,142,731 | 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 | $5,150,653 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,128,137 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,459,738 | PYOtherExpensesAmt |
| CY Other Expenses | $2,166,749 | CYOtherExpensesAmt |
| PY Total Expenses | $7,610,391 | PYTotalExpensesAmt |
| CY Total Expenses | $7,294,886 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $188 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$152,155 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,656,890 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,283,266 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,146,053 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,166,161 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,510,837 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,117,105 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Developing excellent Family Medicine physicians by modeling and teaching compassionate and comprehensive patient care delivered with the highest quality. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,221,352 | ExpenseAmt |
| Revenue | $4,048,292 | RevenueAmt |
| Desc | The Northeast Iowa Medical Education Foundation was founded in 1975 to develop a Family Medicine training program. The Family Medicine Residency Program is the branch of the Foundation which provides physicians with three years of additional training in the specialty of family medicine. During their training, resident physicians provide comprehensive health care under the supervision of board certified family medicine physicians. Upon graduation, these physicians provide a potential source of family physicians settling to practice in the community.Resident training takes place in the hospital setting, in private physician offices and in the Northeast Iowa Family Practice Center. During their three-year training program, the physicians receive training in internal medicine, obstetrics/gynecology, surgery, pediatrics, emergency medicine, family medicine, community medicine, psychiatry and behavioral science, orthopedics, otorhinolaryngology, ophthalmology and dermatology. In addition, they may use elective time to concentrate on specialties and sub-specialties of their choice. Resident physicians provide comprehensive medical care to a group of up to 250 patient families at the Northeast Iowa Family Practice Center. Residents may consult with faculty physicians during patient visits. Patients requiring care in the hospital are seen by both resident and faculty physicians.Area physicians are committed to the Northeast Iowa Family Medicine Residency Program. Nearly all private physicians in the area volunteer to teach the skills and procedures resident physicians will need in private practice. Physicians selected to be residents in the Northeast Iowa Family Medicine Residency Program are all graduates of accredited medical schools. The Waterloo Program recruits medical school graduates of the highest caliber, taking into consideration personal characteristics, aptitude and academic achievements.Graduates of the Northeast Iowa Family Medicine Residency Program are eligible to sit for the certification examination in the specialty of family medicine. This examination is administered by the American Board of Family Medicine, which is the specialty board that certifies family physicians. During the academic year 2014-15, seven residents graduated and will take the examination for certification.The Residency Program is accredited by the Accreditation Council of Graduate Medical Education (ACGME), which is composed of representatives of five national associations interested in medical education. These associations are the American Board of Medical Specialties, American Hospital Association, American Medical Association, Association of American Medical Colleges and the Council of Medical Specialty Societies. The ACGME accredits residency programs through their Residency Review Committees with each specialty having its own committee.Educational activities of the Foundation include the Family Medicine Residency Program, undergraduate medical education, continuing medical education, and medical research. The Foundation is sponsored by Allen Memorial Hospital and Covenant Medical Center.During fiscal year ended June 30, 2015, Northeast Iowa Medical Education Foundation trained 18 resident physicians in the specialty of family medicine and one pharmacy resident in traditional and clinical pharmacy services. Clinical experience in family medicine was also provided for 46 medical students, 16 pharmacy students, three pharmacy residents, two IPPE students, one podiatry student, two podiatry residents, seven athletic training students, two NRP students, one social services student, 16 radiology students, and one MD observership. | Desc |
| Total Program Service Expenses | $6,221,352 | 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 | Yes (1) | 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 | Yes (1) | 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 | 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 | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 96 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Holly Wolff | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3192722538 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2055 Kimball Avenue Ste 101 | AddressLine1Txt |
| City | Waterloo | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50702 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Mark Feldkamp DO | |||||||
| President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tim Horrigan MD | |||||||
| Vice President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jack Duesenbery | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Pamela Delagardelle | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nicholas Goetsch DO | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Raja Akbar MD | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JoAn Headington | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kim Neumann MD | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Angela Townsend MD | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Greg Nelson | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jim Lehman MD | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Anthony A Day MD | |||||||
| Executive Director | 55.00 | Yes (X) | Yes (X) | $285,716 | $0 | $39,122 | |
| Holly Wolff | |||||||
| Administrator | 45.00 | Yes (X) | $23,051 | $0 | $5,696 | ||
| Robert Friedman MD | |||||||
| Undergrad Educ Director | 45.00 | $259,204 | $0 | $31,150 | Yes (X) | ||
| James Poock MD | |||||||
| Assistant Program Director | 45.00 | $226,299 | $0 | $35,662 | Yes (X) | ||
| Suzanne Munns MD | |||||||
| Assistant Program Director | 45.00 | $194,877 | $0 | $31,624 | Yes (X) | ||
| Adam Roise MD | |||||||
| Assistant Program Director | 45.00 | $209,151 | $0 | $16,598 | Yes (X) | ||
| Robert Welshons PAC | |||||||
| Physician's Assistant | 45.00 | $104,768 | $0 | $6,059 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,303,066 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $165,911 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Computer Sense Inc | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 Olive Street | AddressLine1Txt |
| City | Cedar Falls | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50613 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Computer services | ServicesDesc |
| Compensation | $117,150 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $286,397 | GovernmentGrantsAmt |
| All Other Contributions | $2,795,519 | AllOtherContributionsAmt |
| Total Contributions | $3,081,916 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Clinic revenue | 621110 | $3,649,745 | $3,649,745 |
| Research/faculty devel | 900099 | $206,525 | $206,525 |
| Pharmacy residency rei | 900099 | $60,893 | $60,893 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $131,129 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $131,129 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,048,292 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,303 | TotalRevenueColumnAmt |
| Exclusion | $2,303 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,440 | 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 | $4,440 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,440 | TotalRevenueColumnAmt |
| Exclusion | $4,440 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,877 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,097 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,780 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,780 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$2,097 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,877 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,142,731 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,048,292 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$2,097 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,620 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,236 | TotalAmt |
| Management And General | $384,236 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,004,398 | TotalAmt |
| Program Services | $3,891,874 | ProgramServicesAmt |
| Management And General | $112,524 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,797 | TotalAmt |
| Program Services | $147,532 | ProgramServicesAmt |
| Management And General | $4,265 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,420 | TotalAmt |
| Program Services | $331,890 | ProgramServicesAmt |
| Management And General | $8,530 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,286 | TotalAmt |
| Program Services | $212,600 | ProgramServicesAmt |
| Management And General | $34,686 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100 | TotalAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,800 | TotalAmt |
| Management And General | $11,800 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,668 | TotalAmt |
| Program Services | $326,331 | ProgramServicesAmt |
| Management And General | $14,337 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,325 | TotalAmt |
| Management And General | $81,325 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,550 | TotalAmt |
| Program Services | $263,994 | ProgramServicesAmt |
| Management And General | $99,556 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,838 | TotalAmt |
| Program Services | $42,104 | ProgramServicesAmt |
| Management And General | $126,734 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,238 | TotalAmt |
| Program Services | $84,238 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,096 | TotalAmt |
| Program Services | $10,313 | ProgramServicesAmt |
| Management And General | $50,783 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,600 | TotalAmt |
| Management And General | $18,600 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,066 | TotalAmt |
| Program Services | $221,066 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,058 | TotalAmt |
| Management And General | $126,058 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Medical supplies | $296,525 | $296,525 |
| Refund of educ support | $138,533 | $138,533 |
| Success sharing incenti | $138,533 | $138,533 |
| Provision for bad debts | $115,818 | $115,818 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1 | TotalAmt |
| Program Services | $1 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,294,886 | TotalAmt |
| Program Services | $6,221,352 | ProgramServicesAmt |
| Management And General | $1,073,534 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,087,450 | BOYAmt |
| EOY | $1,650,198 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $454,379 | BOYAmt |
| EOY | $206,917 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,896 | BOYAmt |
| EOY | $327,981 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,833 | BOYAmt |
| EOY | $10,833 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,705 | BOYAmt |
| EOY | $66,654 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,901,639 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,021,941 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $915,141 | BOYAmt |
| EOY | $879,698 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $372,055 | BOYAmt |
| EOY | $384,574 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,431 | BOYAmt |
| EOY | $6,411 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,000 | BOYAmt |
| EOY | $750,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,656,890 | BOYAmt |
| EOY | $4,283,266 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $623,523 | BOYAmt |
| EOY | $636,746 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,530 | BOYAmt |
| EOY | $247,102 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,000 | BOYAmt |
| EOY | $1,282,313 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,146,053 | BOYAmt |
| EOY | $2,166,161 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,148,470 | BOYAmt |
| EOY | $1,996,315 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,367 | BOYAmt |
| EOY | $120,790 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,510,837 | BOYAmt |
| EOY | $2,117,105 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,656,890 | BOYAmt |
| EOY | $4,283,266 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$152,155 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | -$241,577 | DonatedServicesAndUseFcltsAmt |
| 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) |
|---|---|---|
| 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 Minus4 Years | $3,228,811 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,462,921 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,463,031 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,476,368 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,081,916 | CurrentTaxYearAmt |
| Total | $16,713,047 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,714,337 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,777,963 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,873,685 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,114,627 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,048,292 | CurrentTaxYearAmt |
| Total | $19,528,904 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,943,148 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,240,884 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,336,716 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,590,995 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,130,208 | CurrentTaxYearAmt |
| Total | $36,241,951 | 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 | $36,241,951 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,180 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,861 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,346 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,707 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,743 | CurrentTaxYearAmt |
| Total | $22,837 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,180 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,861 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,346 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,707 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,743 | CurrentTaxYearAmt |
| Total | $22,837 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,947,328 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,244,745 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,340,062 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,595,702 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,136,951 | CurrentTaxYearAmt |
| Total | $36,264,788 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99950 | PublicSupportPY509Pct |
| Investment Income CY | 0.00060 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $37,693 | BeginningYearBalanceAmt |
| Contributions | $134 | ContributionsAmt |
| Investment Earnings Or Losses | $7,270 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,466 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $595 | AdministrativeExpensesAmt |
| End Year Balance | $43,036 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $34,252 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,309 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,389 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $479 | AdministrativeExpensesAmt |
| End Year Balance | $37,693 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $33,821 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $3,617 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,683 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $503 | AdministrativeExpensesAmt |
| End Year Balance | $34,252 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $35,395 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $155 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,246 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $483 | AdministrativeExpensesAmt |
| End Year Balance | $33,821 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $31,385 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,752 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,255 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $487 | AdministrativeExpensesAmt |
| End Year Balance | $35,395 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,499,374 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,065,798 | DepreciationAmt |
| Book Value | $433,576 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,402,265 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,956,143 | DepreciationAmt |
| Book Value | $446,122 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $879,698 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Estimated insurance recoveries receivable | Desc |
| Book Value | $750,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $750,000 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated claims liability | $750,000 |
| Refund of educational support | $532,313 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,282,313 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,029,010 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$115,818 | OtherRevenueAmt |
| Revenue Not Reported | -$115,818 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,144,828 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$2,097 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$2,097 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,142,731 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,145,676 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $241,577 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $2,097 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $243,674 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,902,002 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $392,884 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $392,884 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,294,886 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | An endowment fund known as the Charles A. Waterbury, Jr., M.D. Endowment Fund has been established at the community foundation. The community foundation manages the fund with the long-term objectives of safeguarding principal, increasing the principal's growth sufficiently to offset any decrease in purchasing power due to inflation, and generating income for distribution to the Foundation. The community foundation has variance power, which allows them to modify the donor's stipulations under certain circumstances as they monitor the changing needs of the community. |
| Part X, Line 2: | The Foundation is organized as an Iowa non-profit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Foundation is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Foundation is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Foundation has determined that it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Foundation believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Foundation would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XI, Line 2d - Other Adjustments: | Provision for bad debts included in expenses for Form 990 -115,818. |
| Part XI, Line 4b - Other Adjustments: | Disposal of assets included in revenue for Form 990 -2,097. |
| Part XII, Line 2d - Other Adjustments: | Disposal of assets included in revenue for Form 990 2,097. |
| Part XII, Line 4b - Other Adjustments: | Success sharing payout included in expenses for Form 990 138,533. Refund of educational support included in expenses for Form 990 138,533. Provision for bad debts included in expenses for Form 990 115,818. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 | Yes (1) | 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Anthony A Day MD | ||||||||||||||
| Executive Director | $281,636 | $0 | $3,973 | $0 | $107 | $0 | $20,649 | $0 | $19,732 | $0 | $326,097 | $0 | $0 | $0 |
| Robert Friedman MD | ||||||||||||||
| Undergrad Educ Director | $255,495 | $0 | $3,602 | $0 | $107 | $0 | $20,129 | $0 | $12,170 | $0 | $291,503 | $0 | $0 | $0 |
| James Poock MD | ||||||||||||||
| Assistant Program Director | $222,969 | $0 | $3,223 | $0 | $107 | $0 | $17,664 | $0 | $19,045 | $0 | $263,008 | $0 | $0 | $0 |
| Suzanne Munns MD | ||||||||||||||
| Assistant Program Director | $191,953 | $0 | $2,817 | $0 | $107 | $0 | $14,318 | $0 | $18,243 | $0 | $227,438 | $0 | $0 | $0 |
| Adam Roise MD | ||||||||||||||
| Assistant Program Director | $206,328 | $0 | $2,716 | $0 | $107 | $0 | $10,574 | $0 | $6,934 | $0 | $226,659 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 6 | FormAndLineReferenceDesc |
| Explanation | A Success Sharing Policy has been approved by the Board of Directors which allows all employees, including those listed in Part VII, to be eligible for additional financial compensation based upon the financial success (net earnings) of the Organization and other quality measures. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dr Adam Roise | PersonNm |
| Loan Purpose | Student loan advance as part of a recruitment agreement | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $50,000 | OriginalPrincipalAmt |
| Balance Due | $10,833 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $10,833 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | The Executive Committee is composed of the officers elected by the Board of Directors. The Executive Committee has authority to transact all regular business of the organization during the period between the meetings of the Board of Directors subject to any prior limitation imposed by the Board of Directors. |
| Form 990, Part VI, Section A, line 2 | Pam Delagardelle, Nicholas Goetsch, DO, Tim Horrigan, MD, Raja Akbar, MD, and JoAn Headington have a business relationship. Mark Feldkamp, DO, Jack Dusenbery, Angela Townsend, MD, Jim Lehman, MD, and Kim Neumann, MD have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The members of Northeast Iowa Medical Education Foundation are Allen Memorial Hospital Corporation and Covenant Health System. New members may be admitted only with the unanimous consent of the present members. |
| Form 990, Part VI, Section A, line 7a | The two members, Allen Memorial Hospital Corporation and Covenant Health System, appoint the Board of Directors of Northeast Iowa Medical Education Foundation Inc. The President/Chief Executive Officer of each of the Members are automatically, by virtue of their office, Directors of this corporation. The Executive Director of the Northeast Iowa Medical Education Foundation, Inc. serves on the Board. A representative of the University of Iowa College of Medicine serves on the Board as appointed by the Dean of the College. Each Member appoints to the Board of Directors two persons who are members of the medical staff of the appointing Member, and two persons who are also directors of the appointing Member, or an affiliated organization of such appointing Member. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is provided to the governing body. The Executive Director and Administrator review the 990 before it is filed. |
| Form 990, Part VI, Section B, line 12c | Board members and officers are required to sign a conflict of interest statement annually. The statements are reviewed by the Administrator of the organization. Any potential conflict is brought to the Board's attention for discussion. In the event of a potential conflict, the Member will disclose the potential conflict and either abstain from involvement or discussion of the issue leading to the conflict or resign. |
| Form 990, Part VI, Section B, line 15a | The Executive Director's compensation is determined by the Executive Committee of the Board with salary adjustment recommendations based on an annual individual performance evaluation and review of Medical Group compensation surveys published by MGMA, AMGA, and University of Iowa compensation survey of Iowa medical residency programs including size of groups, ownership, productivity, and geographic area. The Executive Director determines the Administrator's compensation annually based on the above process. The Organization documents and provides substantiation for their compensation process. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon written request. |
Comments