NORTHERN HEALTH CENTERS INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN HEALTH CENTERS INC (EIN 39-1550213)
- Tax period
- 2014-02-01 to 2015-01-31
- Filed
- 2015-08-03
- IRS object ID
- 201522159349300217
- 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 | 2015-08-03T09:32:26-05:00 | ReturnTs |
| Tax Period End | 2015-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43A W DAVENPORT ST | AddressLine1Txt |
| City | RHINELANDER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391550213 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 7152766321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | LAKEWOOD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54138 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELE WHITE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7152766321 | PhoneNum |
| Signature | 2015-07-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RANDALL H BEARD CPA | PreparerPersonNm |
| PTIN | P00023289 | PTIN |
| Phone | 7153691040 | PhoneNum |
| Preparation | 2015-07-24 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHELE WHITE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | LAKEWOOD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54138 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,782,036 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NHCMEDDEN.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 78 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $862,570 | PYContributionsGrantsAmt |
| CY Contributions Grants | $997,391 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,329,253 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,774,512 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,957 | PYOtherRevenueAmt |
| CY Other Revenue | $6,455 | CYOtherRevenueAmt |
| PY Total Revenue | $4,198,780 | PYTotalRevenueAmt |
| CY Total Revenue | $4,778,358 | 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 | $3,128,111 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,608,082 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,347,471 | PYOtherExpensesAmt |
| CY Other Expenses | $1,350,232 | CYOtherExpensesAmt |
| PY Total Expenses | $4,475,582 | PYTotalExpensesAmt |
| CY Total Expenses | $4,958,314 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$276,802 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$179,956 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,757,035 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,561,773 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,404,723 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,389,417 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,352,312 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,172,356 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE OUR COMMUNITY HEALTH BY PROVIDING ALL PERSONS A COMPREHENSIVE PROGRAM OF QUALITY FAMILY ORIENTED PRIMARY HEALTH CARE SERVICES REGARDLESS OF THEIR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,530,375 | ExpenseAmt |
| Revenue | $3,751,764 | RevenueAmt |
| Desc | NORTHERN HEALTH CENTERS, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER LOCATED IN NORTHEAST WISCONSIN. WE ARE A COMMUNITY HEALTH CENTER SERVING A MEDICALLY UNDERSERVED POPULATION WITHIN A FIVE COUNTY RADIUS. THE SERVICES PROVIDED TO OUR PATIENT POPULATION ARE MEDICAL, DENTAL, BEHAVIORAL HEALTH CARE AND ENABLING SERVICES. NHC CONTINUES TO PROVIDE PREVENTIVE DENTAL SERVICES TO THE UNDERSERVED CHILDREN THROUGH OUR SEAL-A-SMILE PROGRAM WHICH WAS IMPLEMENTED IN 2010; WE HAVE INCREASED THE NUMBER OF SCHOOLS WE PROVIDE SEALANTS TO FROM 15 TO 24 SCHOOLS IN THREE COUNTIES. | Desc |
| Total Program Service Expenses | $3,530,375 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 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 | 36 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 78 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHELE WHITE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7152766321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15397 HWY 32 | AddressLine1Txt |
| City | LAKEWOOD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54138 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 |
|---|---|---|---|---|---|---|---|
| MARGARAT BLAIR | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KAYLYN HALVORSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JANICE LEIBSH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY WHITING | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BOB BROWN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAAL HANSEN | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GAIL NELSON | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RAY SCHEIFEN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY JURMAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHELE WHITE | |||||||
| EXECUTIVE DIRECTOR | 41.00 | Yes (X) | $98,529 | $0 | $11,792 | ||
| HOLLY LIPTACK | |||||||
| CHEIFT FINANCIAL OFFICER | 40.00 | Yes (X) | $62,368 | $0 | $5,221 | ||
| TED JUNG | |||||||
| DENTIST | 40.00 | $157,850 | $0 | $18,599 | Yes (X) | ||
| STEPHANIE REIMER | |||||||
| DENTIST | 40.00 | $161,592 | $0 | $14,347 | Yes (X) | ||
| LANCE ORLINSKI | |||||||
| DENTIST | 40.00 | $124,160 | $0 | $13,526 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $604,499 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $63,485 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WPS INSURANCE | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 W BROADWAY | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53708 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | HEALTH INSURANCE FOR EMPLOYEES | ServicesDesc |
| Compensation | $225,085 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $994,725 | GovernmentGrantsAmt |
| All Other Contributions | $2,666 | AllOtherContributionsAmt |
| Total Contributions | $997,391 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL & DENTAL SERVI | 621110 | $1,898,034 | $1,898,034 |
| FQHC REIMBURSEMENTS | 621110 | $1,806,723 | $1,806,723 |
| NURSING REVENUE | 621110 | $69,755 | $69,755 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,774,512 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $10,133 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $3,678 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,455 | TotalRevenueColumnAmt |
| Exclusion | $6,455 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,778,358 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,774,512 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,455 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,080,845 | TotalAmt |
| Program Services | $2,138,108 | ProgramServicesAmt |
| Management And General | $942,737 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $527,237 | TotalAmt |
| Program Services | $334,878 | ProgramServicesAmt |
| Management And General | $192,359 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,058 | TotalAmt |
| Program Services | $8,102 | ProgramServicesAmt |
| Management And General | $59,956 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $301,314 | TotalAmt |
| Program Services | $295,477 | ProgramServicesAmt |
| Management And General | $5,837 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,781 | TotalAmt |
| Management And General | $31,781 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,856 | TotalAmt |
| Program Services | $8,626 | ProgramServicesAmt |
| Management And General | $31,230 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,549 | TotalAmt |
| Program Services | $23,895 | ProgramServicesAmt |
| Management And General | $2,654 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,147 | TotalAmt |
| Program Services | $33,925 | ProgramServicesAmt |
| Management And General | $8,222 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,743 | TotalAmt |
| Management And General | $46,743 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,941 | TotalAmt |
| Program Services | $162,300 | ProgramServicesAmt |
| Management And General | $15,641 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,438 | TotalAmt |
| Management And General | $42,438 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & DENTAL SUPPLI | $277,040 | $277,040 | |
| REPAIRS AND MAINTENANCE | $83,154 | $83,061 | $93 |
| BAD DEBT EXPENSE | $66,390 | $66,390 | |
| SPACE RENT | $58,555 | $58,555 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,266 | TotalAmt |
| Program Services | $40,018 | ProgramServicesAmt |
| Management And General | $48,248 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,958,314 | TotalAmt |
| Program Services | $3,530,375 | ProgramServicesAmt |
| Management And General | $1,427,939 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,130 | BOYAmt |
| EOY | $28,302 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,361 | BOYAmt |
| EOY | $5,368 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $296,016 | BOYAmt |
| EOY | $317,164 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,558 | BOYAmt |
| EOY | $375,904 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,792 | BOYAmt |
| EOY | $48,908 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,608 | BOYAmt |
| EOY | $31,499 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,088,658 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,337,680 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,928,920 | BOYAmt |
| EOY | $1,750,978 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,650 | BOYAmt |
| EOY | $3,650 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,757,035 | BOYAmt |
| EOY | $2,561,773 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,377 | BOYAmt |
| EOY | $333,816 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,150,584 | BOYAmt |
| EOY | $1,055,601 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,762 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,404,723 | BOYAmt |
| EOY | $1,389,417 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,352,312 | BOYAmt |
| EOY | $1,172,356 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,352,312 | BOYAmt |
| EOY | $1,172,356 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,757,035 | BOYAmt |
| EOY | $2,561,773 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$179,956 | 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 |
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,168,946 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $768,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $749,909 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $862,570 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $980,791 | CurrentTaxYearAmt |
| Total | $4,531,018 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,168,946 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $768,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $749,909 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $862,570 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $980,791 | CurrentTaxYearAmt |
| Total | $4,531,018 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $4,531,018 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $502 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $403 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $311 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $198 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $142 | CurrentTaxYearAmt |
| Total | $1,556 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,396 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,065 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,709 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,957 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,455 | CurrentTaxYearAmt |
| Total | $75,582 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,608,156 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $15,160,372 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98330 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98180 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $84,293 | OtherCostOrOtherBasisAmt |
| Book Value | $84,293 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $861,149 | OtherCostOrOtherBasisAmt |
| Depreciation | $363,749 | DepreciationAmt |
| Book Value | $497,400 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $659,355 | OtherCostOrOtherBasisAmt |
| Depreciation | $107,592 | DepreciationAmt |
| Book Value | $551,763 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,483,861 | OtherCostOrOtherBasisAmt |
| Depreciation | $866,339 | DepreciationAmt |
| Book Value | $617,522 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,750,978 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,778,358 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,778,358 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,778,358 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,958,314 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,958,314 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,958,314 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A NON-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES. THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OR THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. FEDERAL RETURNS FOR THE YEARS ENDED 2011 AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TED JUNG | ||||||||||||||
| DENTIST | $157,850 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,599 | $0 | $176,449 | $0 | $0 | $0 |
| STEPHANIE REIMER | ||||||||||||||
| DENTIST | $161,592 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,347 | $0 | $175,939 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY WAS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE AUDITING FIRM ALSO PRESENTED COMPREHENSIVE AUDIT INFORMATION DIRECTLY TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOTH STAFF AND BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT IDENTIFYING ANY CONFLICTS ON AN ANNUAL BASIS. STAFF HAS RECEIVED REQUIRED TRAINING ON THE POLICY AND IT IS MONITORED ON A MONTHLY BASIS. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND ADDRESSING ANY ISSUES AS A RESULT OF THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DETERMINED BY PERFORMANCE COUPLED WITH PREVAILING INDUSTRY STANDARDS AND THE CURRENT NACHC COMPENSATION REPORT. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL STAFF AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. STAFF RECEIVES REQUIRED TRAINING UPON HIRE AND AT LEAST ANNUALLY THEREAFTER. THERE ARE ESTABLISHED POLICIES FOR REPORTING AND RESPONDING TO VIOLATIONS OF THE CONFLICT OF INTEREST POLICY WHICH IS PART OF THE LARGER NHC CORPORATE COMPLIANT POLICY. NHCS CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING ANY CONFLICTS OF INTEREST AND FOLLOWING ESTABLISHED POLICY TO ADDRESS AND REPORTS OF VIOLATIONS. |
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