NEIGHBORHOOD HEALTH CLINICS INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- NEIGHBORHOOD HEALTH CLINICS INC (EIN 35-1922483)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-08-11
- IRS object ID
- 201532239349300243
- 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 | 2015-08-11T11:00:09-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 E Jefferson Blvd | AddressLine1Txt |
| Address Line2 | PO Box 7 | AddressLine2Txt |
| City | South Bend | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 466240007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351922483 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Neighborhood Health Clinics Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEIG | BusinessNameControlTxt |
| Phone | 2604582641 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 South Calhoun Street | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary S Haupert | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Signature | 2015-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Erica Cherry | PreparerPersonNm |
| PTIN | P01320580 | PTIN |
| Phone | 5742323992 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mary Haupert | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 South Calhoun Street | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,696,974 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.nhci.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | The organization's mission is to identify the needs of and provide quality healthcare services to the community with respect and sensitivity to those being served. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 21 | VotingMembersIndependentCnt |
| Total Employee | 167 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,956,188 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,271,363 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,408,379 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,418,563 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,849 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,996 | CYInvestmentIncomeAmt |
| PY Other Revenue | $12,357 | PYOtherRevenueAmt |
| CY Other Revenue | $5,052 | CYOtherRevenueAmt |
| PY Total Revenue | $11,380,773 | PYTotalRevenueAmt |
| CY Total Revenue | $9,696,974 | 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 | $5,588,260 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,309,321 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $88,725 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,130,018 | PYOtherExpensesAmt |
| CY Other Expenses | $3,726,572 | CYOtherExpensesAmt |
| PY Total Expenses | $8,718,278 | PYTotalExpensesAmt |
| CY Total Expenses | $10,035,893 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,662,495 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$338,919 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,080,094 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,919,512 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $857,968 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,036,305 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,222,126 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,883,207 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The purpose of Neighborhood Health Clinics, Inc. is to identify the needs of and provide quality healthcare services to the community with respect and sensitivity to those being served. Neighborhood Health Clinics, Inc. (hereby referred to as "NHCI") is a non-profit organization that provides medical, dental, nutritional, and other health related services to Allen and surrounding counties in Indiana. NHCI has been providing services since 1969. Originally, the agency was known as Three Rivers Neighborhood Health Services and was founded by the Allen County Medical Society as a voluntary health service to provide well child services to low-income children of Allen County. In 1994, the name was changed and services were expanded to include a full continuum of primary medical services for all genders and ages. In 1998, a full-service dental clinic was established. Neighborhood Health Clinics offers various state grant programs including the Women's, Infant and Children nutritional | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,734,766 | ExpenseAmt |
| Revenue | $3,418,563 | RevenueAmt |
| Desc | NEIGHBORHOOD HEALTH CLINICS, INC. (NHCI) PROVIDES QUALITY COMPREHENSIVE CARE, INCLUDING MEDICAL AND DENTAL SERVICES, TO INDIVIDUALS WHO ARE UNABLE TO ACCESS THE NORMAL HEALTH CARE SYSTEM. NHCI'S MAIN OFFICE IS LOCATED IN A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA WHERE FEW OTHER MEDICAL/DENTAL SERVICES ARE AVAILABLE. DURING 2014, NHCI PROVIDED MEDICAL SERVICES TO 9,675 INDIVIDUALS AND DENTAL SERVICES TO 7,258 INDIVIDUALS. OF THE INDIVIDUALS SERVED, 39% WERE AT OR BELOW THE POVERTY LEVEL; 73% WERE MINORITIES; AND 93% WERE EITHER MEDICARE/MEDICAID RECIPIENTS OR WERE UNINSURED. AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), NHCI PROVIDES SERVICES TO QUALIFIED INDIVIDUALS ON A SLIDING FEE SCALE BASED ON THEIR ABILITY TO PAY; DURING 2014 NHCI PROVIDED A TOTAL OF $2,786,962 IN DISCOUNTED SERVICES. NHCI'S MEDICAL SERVICES INCLUDE: - FAMILY MEDICINE - PREVENTATIVE MEDICINE AND SCREENING, ACUTE AND CHRONIC MANAGEMENT OF GENERAL DISEASE; - PEDIATRICS - WELL CHILD CARE; ACUTE AND CHRONIC CARE OF GENERAL PEDIATRIC DISEASE; - PRENATAL - FREE PREGNANCY TESTS; GENERAL PRENATAL CARE AND DELIVERY SERVICES; POST-PARTUM CARE; AND - WOMEN'S HEALTH - PREVENTATIVE AND WELL CARE, CONTRACEPTION, GYNECOLOGICAL SCREENING, ACUTE AND CHRONIC GYNECOLOGICAL CARE. NHCI'S DENTAL SERVICES INCLUDE: FULL FAMILY DENTAL CARE (PEDIATRIC DENTAL PATIENTS STARTING AT AGE 3); CAVITY PREVENTION; CAVITY TREATMENT; DENTAL X-RAYS; EXTRACTIONS; CROWNS; DENTURES; AND PROTECTIVE SEALANTS. NHCI ALSO PARTICIPATES IN THE WIC PROGRAM, A NUTRITION EDUCATION PROGRAM OFFERING HEALTHY FOODS AND OTHER SERVICES FREE OF CHARGE. THE WIC PROGRAM HELPS MANY FAMILIES (SINGLE PARENTS, MARRIED, WORKING, NOT WORKING, AND FOSTER PARENTS). EACH MONTH, APPROXIMATELY 12,500 CHILDREN AGES 0-5 RECEIVE NUTRITION COUNSELING AND VOUCHERS FOR NUTRITIOUS FOOD FROM NHCI'S WIC PROGRAM IN ALLEN, DEKALB, AND NOBLE COUNTIES. | Desc |
| Total Program Service Expenses | $8,734,766 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 167 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 21 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Richard Yergler | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2604582648 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 South Calhoun Street | AddressLine1Txt |
| City | Fort Wayne | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46802 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 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 |
|---|---|---|---|---|---|---|---|
| Terry Broberg-Swangin | |||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nanette Baker | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| J Phillip Tyndall MD | |||||||
| 1st Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Holli Seabury | |||||||
| 2nd Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Scott Jackson | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Joe Cohen | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Donna Spina | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| James Fisher | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Joseph O'Dell | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dennis Becker | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Angela Ruiz | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Harout Kouyoumdjian | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Dollye Carlisle | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Shabbir Morriswalla | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Theresa York | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Anita Craig | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kayevonne Dailey | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Johnathon Liechty | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Mario Vaides | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jeff Vice | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Benjamin Yoder DDS | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Yergler | |||||||
| VP/CFO | 40.00 | Yes (X) | $62,966 | $0 | $20,971 | ||
| Mary S Haupert | |||||||
| President/CEO | 40.00 | Yes (X) | $105,655 | $0 | $21,998 | ||
| Angie Zaegal | |||||||
| VP/COO | 40.00 | Yes (X) | $71,180 | $0 | $3,689 | ||
| Dr Thomas Stafford | |||||||
| VP/CMO | 36.00 | Yes (X) | $174,961 | $0 | $17,070 | ||
| Dr Carolyn Yap | |||||||
| Family Practice MD | 40.00 | $172,722 | $0 | $10,078 | Yes (X) | ||
| Dr Piyush Kumar | |||||||
| Family Practice MD | 40.00 | $163,015 | $0 | $26,475 | Yes (X) | ||
| Dr Goldy Carbunaru | |||||||
| Pediatrician | 30.00 | $102,577 | $0 | $26,982 | Yes (X) | ||
| Dr Cynthia Vanderbosch | |||||||
| Family Practice MD | 32.00 | $113,008 | $0 | $413 | Yes (X) | ||
| Tyler Kimmel DDS | |||||||
| Dentist/Dental Director | 40.00 | $139,668 | $0 | $8,582 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,105,752 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $136,258 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PARKVIEW HOSPITAL | |||||
| 2200 RANDALLIA DRIVE | FORT WAYNE | IN | 46805 | LABORATORY SERVICES | $213,343 |
| MAINSTAY SOLUTIONS | |||||
| PO BOX 15562 | FORT WAYNE | IN | 46885 | IT SERVICE | $118,166 |
| PRIORITY MANAGEMENT GROUP | |||||
| 700 SCHOOL STREET | PAWTUCKET | RI | 02860 | ACCTS RECEIVABLE/BILLING SERVICE | $102,451 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $166,667 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $5,360,504 | GovernmentGrantsAmt |
| All Other Contributions | $744,192 | AllOtherContributionsAmt |
| Noncash Contributions | $261,846 | NoncashContributionsAmt |
| Total Contributions | $6,271,363 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net patient service revenue | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $3,418,563 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,418,563 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,418,563 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,996 | TotalRevenueColumnAmt |
| Exclusion | $1,996 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,594 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,594 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,594 | TotalRevenueColumnAmt |
| Exclusion | $4,594 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $458 | TotalRevenueColumnAmt |
| Exclusion | $458 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $458 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,696,974 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,418,563 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,048 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $478,487 | TotalAmt |
| Program Services | $84,493 | ProgramServicesAmt |
| Management And General | $393,994 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,734,499 | TotalAmt |
| Program Services | $4,483,563 | ProgramServicesAmt |
| Management And General | $181,257 | ManagementAndGeneralAmt |
| Fundraising | $69,679 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,772 | TotalAmt |
| Program Services | $50,543 | ProgramServicesAmt |
| Management And General | $21,434 | ManagementAndGeneralAmt |
| Fundraising | $795 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660,892 | TotalAmt |
| Program Services | $645,967 | ProgramServicesAmt |
| Management And General | $4,930 | ManagementAndGeneralAmt |
| Fundraising | $9,995 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,671 | TotalAmt |
| Program Services | $317,567 | ProgramServicesAmt |
| Management And General | $40,196 | ManagementAndGeneralAmt |
| Fundraising | $4,908 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,976 | TotalAmt |
| Program Services | $2,562 | ProgramServicesAmt |
| Management And General | $10,414 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,418 | TotalAmt |
| Program Services | $44,639 | ProgramServicesAmt |
| Management And General | $8,779 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $812,671 | TotalAmt |
| Program Services | $769,968 | ProgramServicesAmt |
| Management And General | $42,703 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,926 | TotalAmt |
| Program Services | $28,059 | ProgramServicesAmt |
| Management And General | $2,867 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,988 | TotalAmt |
| Program Services | $180,852 | ProgramServicesAmt |
| Management And General | $46,788 | ManagementAndGeneralAmt |
| Fundraising | $3,348 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,742 | TotalAmt |
| Program Services | $55,442 | ProgramServicesAmt |
| Management And General | $300 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,013,042 | TotalAmt |
| Program Services | $858,123 | ProgramServicesAmt |
| Management And General | $154,919 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,442 | TotalAmt |
| Program Services | $37,823 | ProgramServicesAmt |
| Management And General | $7,619 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,632 | TotalAmt |
| Program Services | $2,333 | ProgramServicesAmt |
| Management And General | $3,299 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $306,798 | TotalAmt |
| Program Services | $55,957 | ProgramServicesAmt |
| Management And General | $250,841 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,268 | TotalAmt |
| Program Services | $45,856 | ProgramServicesAmt |
| Management And General | $1,412 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $635,302 | $635,302 | |
| Bad Debt Expense | $402,137 | $402,137 | |
| Dues & Subscriptions | $47,579 | $14,031 | $33,548 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,651 | TotalAmt |
| Program Services | $19,548 | ProgramServicesAmt |
| Management And General | $7,103 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,035,893 | TotalAmt |
| Program Services | $8,734,765 | ProgramServicesAmt |
| Management And General | $1,212,403 | ManagementAndGeneralAmt |
| Fundraising | $88,725 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,171,833 | BOYAmt |
| EOY | $1,292,192 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,153,934 | BOYAmt |
| EOY | $1,023,365 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,963 | BOYAmt |
| EOY | $366,869 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,711 | BOYAmt |
| EOY | $107,313 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,816,515 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,686,742 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,398,653 | BOYAmt |
| EOY | $8,129,773 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,080,094 | BOYAmt |
| EOY | $10,919,512 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $498,379 | BOYAmt |
| EOY | $698,456 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,589 | BOYAmt |
| EOY | $337,849 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857,968 | BOYAmt |
| EOY | $1,036,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,995,109 | BOYAmt |
| EOY | $9,569,941 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,017 | BOYAmt |
| EOY | $293,266 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,000 | BOYAmt |
| EOY | $20,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,222,126 | BOYAmt |
| EOY | $9,883,207 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,080,094 | BOYAmt |
| EOY | $10,919,512 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$338,919 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $5,224,844 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,737,588 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,076,484 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,956,188 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,271,363 | CurrentTaxYearAmt |
| Total | $35,266,467 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,224,844 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,737,588 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,076,484 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,956,188 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,271,363 | CurrentTaxYearAmt |
| Total | $35,266,467 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $35,266,467 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,636 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,125 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,682 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,254 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,590 | CurrentTaxYearAmt |
| Total | $24,287 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,391 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,074 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,079 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,952 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $458 | CurrentTaxYearAmt |
| Total | $16,954 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $35,307,708 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $17,205,864 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.9988 | PublicSupportCY170Pct |
| Public Support PY170 | 0.9988 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - MISCELLANEOUS, COLUMN A - 1391.0, COLUMN B - 1074.0, COLUMN C - 5079.0, COLUMN D - 8952.0, COLUMN E - 458.0, COLUMN F - 16954.0; | ExplanationTxt |
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 | $20,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $22 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $22 | AdministrativeExpensesAmt |
| End Year Balance | $20,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $25 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $25 | AdministrativeExpensesAmt |
| End Year Balance | $20,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $42 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $42 | AdministrativeExpensesAmt |
| End Year Balance | $20,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $55 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $55 | AdministrativeExpensesAmt |
| End Year Balance | $20,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $59 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $59 | AdministrativeExpensesAmt |
| End Year Balance | $20,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.0 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $133,500 | OtherCostOrOtherBasisAmt |
| Book Value | $133,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,574,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $282,971 | DepreciationAmt |
| Book Value | $7,291,800 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,165,106 | OtherCostOrOtherBasisAmt |
| Depreciation | $630,777 | DepreciationAmt |
| Book Value | $534,329 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $943,138 | OtherCostOrOtherBasisAmt |
| Depreciation | $772,994 | DepreciationAmt |
| Book Value | $170,144 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,129,773 | TotalBookValueLandBuildingsAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,921,304 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $224,330 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $224,330 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,696,974 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,696,974 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,260,223 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $224,330 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $224,330 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,035,893 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,035,893 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 Intended uses of endowment funds | Endowment earnings are used to offset the fees not covered by sliding fee patients. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | The Organization is exempt from income taxes on income from related activities under Section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. U.S. GAAP requires that a tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Due to its tax-exempt status, the Organization is not generally subject to U.S. federal income tax or state income tax. The Organization's Form 990 has not been subject to examination by the Internal Revenue Service or the state of Indiana for the last three years. The Organization does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Organization recognizes interest and/or penalties related to income tax matters in income tax expense. The Organization did not have any amounts accrued for interest and penalties at December 31, 2014 and 2013. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Thomas Stafford | ||||||||||||||
| VP/CMO | $174,961 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $17,070 | $0 | $192,031 | $0 | $0 | $0 |
| Dr Carolyn Yap | ||||||||||||||
| Family Practice MD | $172,722 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,078 | $0 | $182,800 | $0 | $0 | $0 |
| Dr Piyush Kumar | ||||||||||||||
| Family Practice MD | $163,015 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,475 | $0 | $189,490 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 4863 | ContributionCnt |
| Noncash Contributions Rpt F990 | $261,845 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Cost | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule M, Part I Explanations of reporting method for number on contributions | Drugs and medical supplies: Number of immunizations received. VACCINES FOR CHILDREN IS A STATE BASED PROGRAM THAT PROVIDES FREE VACCINES FOR KIDS. WE RECORD THE VALUE PER SHIPPING DOCUMENT WHEN THE SUPPLIES ARE RECEIVED FROM THE PROGRAM. |
| Schedule M, Part I, Line 20 Number of contributions or items contributed | Number of immunizations received. VACCINES FOR CHILDREN IS A STATE BASED PROGRAM THAT PROVIDES FREE VACCINES FOR KIDS. WE RECORD THE VALUE PER SHIPPING DOCUMENT WHEN THE SUPPLIES ARE RECEIVED FROM THE PROGRAM. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES | SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The Executive Committee shall consist of the officers of the Corporation. The officers of the Corporation shall be members of the Board of Directors and consist of a Chair, Vice Chair, a Second Vice Chair, a Secretary, and a Treasurer. Only the offices of Secretary and Treasurer may be held by the same person. The Board of Directors may, by resolution or resolutions passed by majority of the whole Board, empower the Executive Committee to act for and on behalf of the Board between meetings of the Board and to have and exercise all of the power of the Board in accordance with the general policy of the Board. When acting for or on behalf of the Board of Directors, the Executive Committee shall keep due record of all meetings and actions of the Committee and such records shall at all times be open to the inspection of any Director and from time to time shall be filed with the Board of Directors at the meetings thereof. Such records, and all actions of the Committee recorded therein, shall be subject to the supervision and ratification of the Board. Notwithstanding the foregoing, the designation of such an Executive Committee and the delegation thereto of authority shall not operate to relieve the Board of Directors or any member thereof of any responsibility imposed on it or on any member by law. The functions of the Executive Committee may be performed by meetings of the Committee held in the regular way or by a majority of the members thereof, who being in communication with each other either by letter or telephone, may decide any matters coming within the scope of the Committee's powers. A majority of the members of the Committee shall constitute a quorum at such meetings for the transaction of business. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The organization's Finance Committee reviews the full Form 990 in detail prior to it being finalized and filed. Then each member of the full Board of directors also receives a copy of the Form 990 prior to filing. |
| Form 990, Part VI, Line 12c Conflict of interest policy | A possible conflict of interest exists if the director, principal officer, key employee or committee member has, either directly or through family: (a) An ownership or investment interest in any entity with which NHCI has a transaction or arrangement, (b) A compensation arrangement with NHCI or with any entity or individual with whom NHCI has a transaction or arrangement, or (c) A potential ownership or investment interest in, or compensation arrangement with, any entity or individual with whom NHCI is negotiating a transaction arrangement. Compensation includes direct and indirect remuneration, as well as gifts or favors that are considered substantial. The organization's board members and officers sign an annual conflict of interest statement and complete an annual conflict of interest questionnaire. The organization's President/CEO and board Chair review the responses to determine if any potential conflicts of interest exist. Where any of the above exists for any possible transaction, the person has a duty to disclose the existence of the relationship and all material facts of the relationship to the Board of Directors or committee. After full disclosure, the Board or committee will determine if a conflict on interest exists. Anyone with a conflict of interest must excuse himself or herself from the discussion and/or vote for any conflicting issues. In addition, if a conflict of interest is determined to exist, the board or committee may: (A) Determine if NHCI can obtain a more advantageous transaction or arrangement that does not result in a conflict of interest, or (B) Determine by a majority vote of the disinterested Directors whether the transaction or arrangement is in NHCI's best interest, for its own benefit, and whether it is fair and reasonable and enter into the transaction or arrangement. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | At least every three years, HR performs a salary analysis which covers all positions within the organization; the most recent salary analysis occurred in August 2014. The salary analysis is based on salary surveys including like organizations and the local wages paid in the Fort Wayne area. The data from the salary survey is then used by the board of directors to determine salary ranges for all positions within the organization until another salary survey is completed, usually within three years. The board reviews and approves the salary ranges for all positions, and documents their findings in the board meeting minutes. In addition, the board of directors reviews and approves any raises for the organization's President/CEO and other officers annually in January when the organization's budget is reviewed and approved, which is documented in the board meeting minutes. The board of directors also completes the President/CEO's performance review; the President/CEO completes the performance reviews for all other officers. Any raises approved by the board are set as a percentage, which is based on the outcome of the performance review. Total compensation must stay within the compensation range set by the most recent HR salary analysis. This review process was last undertaken in April 2014. |
| Form 990, Part VI, Line 19 Required documents available to the public | Governing documents, conflict of interest policies, and financial statements are not required disclosures pursuant to internal revenue code section 6104. These documents are not available to the public at this time. |
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