GUILFORD ADULT HEALTH INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
GUILFORD ADULT HEALTH INC (EIN 04-3726317)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-04-08
IRS object ID
201540989349300234
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-04-08T15:40:33-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN561146197PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SHARRARD MCGEE & CO PABusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 10439AddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code274040439ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043726317EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GUILFORD ADULT HEALTH INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlGUILBusinessNameControlTxt
Phone3365559700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 S EUGENE STREETAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27406ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMS LISA DUCKPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3365559700PhoneNum
Signature2015-03-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDENNIS A NEWMANPreparerPersonNm
PTINP01221886PTIN
Phone3362729777PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMS LISA DUCKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 S EUGENE STREETAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27406ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$336,230GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GUILFORDCCN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE ACCESSIBLE, AFFORDABLE, AND QUALITY MEDICAL AND DENTAL SERVICES TO GUILFORD COUNTY RESIDENTS WITH INCOMES BETWEEN 0% AND 200% OF THE FEDERAL POVERTY LEVEL.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$763,491PYContributionsGrantsAmt
CY Contributions Grants$300,190CYContributionsGrantsAmt
PY Program Service Revenue$21,325PYProgramServiceRevenueAmt
CY Program Service Revenue$36,040CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$784,816PYTotalRevenueAmt
CY Total Revenue$336,230CYTotalRevenueAmt
PY Grants And Similar Paid$456,932PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$342,134CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$337,033PYOtherExpensesAmt
CY Other Expenses$242,194CYOtherExpensesAmt
PY Total Expenses$793,965PYTotalExpensesAmt
CY Total Expenses$584,328CYTotalExpensesAmt
PY Revenues Less Expenses-$9,149PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$248,098CYRevenuesLessExpensesAmt
Total Assets BOY$1,101,341TotalAssetsBOYAmt
Total Assets EOY$852,666TotalAssetsEOYAmt
Total Liabilities BOY$49,840TotalLiabilitiesBOYAmt
Total Liabilities EOY$35,663TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,051,501NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$817,003NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE LONG-TERM SECURE FUNDING FOR INDIGENT CARE AND BE AN ADVOCATE FOR THE COMMUNITY AND CLIENTS SERVED BY CLINICS IN THE AREA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$565,782ExpenseAmt
Grant$342,134GrantAmt
Revenue$36,040RevenueAmt
DescGUILFORD ADULT HEALTH PROVIDED DENTAL SERVICES TO PATIENTS BELOW POVERTY LEVEL, CREATED AND ADMINISTERED AN INFORMATION SHARING NETWORK FOR ELIGIBILITY PROCESS FOR INDIGENT PATIENTS, AND FUNDED OTHER ORGANIZATIONS PROVIDING PRIMARY MEDICAL CARE SERVICES.Desc
Total Program Service Expenses$565,782TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DESHANDRA WOODLEBusinessNameLine1
FieldValueIRS element (for citing)
Phone3363559696PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 S EUGENE STREETAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27406ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
LISA DUCK
EXECUTIVE DIRECTOR20.00Yes (X)Yes (X)$73,550$0$0
MERLE GREEN
BOARD MEMBER1.00Yes (X)$0$0$0
PATRICIA A SOENKSEN
BOARD MEMBER1.00Yes (X)$0$0$0
TIM CLONTZ
VICE CHAIRPERSON/SECRETARY1.00Yes (X)Yes (X)$0$0$0
CHESTER BROWN III
BOARD MEMBER1.00Yes (X)$0$0$0
ANGIE ORTH
BOARD MEMBER1.00Yes (X)$0$0$0
MARTY LAWING
BOARD MEMBER1.00Yes (X)$0$0$0
CARIN HIOTT
BOARD MEMBER1.00Yes (X)$0$0$0
BRIAN ELLERBY
EX-OFFICIO1.00Yes (X)$0$0$0
DENISE POTTER
BOARD MEMBER1.00Yes (X)$0$0$0
AASHKA MEHTA
BOARD MEMBER1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$73,550TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$19,230GovernmentGrantsAmt
All Other Contributions$280,960AllOtherContributionsAmt
Total Contributions$300,190TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSERVICE REVENUEDesc
Business624100BusinessCd
Total Revenue Column$36,040TotalRevenueColumnAmt
Related Or Exempt Func Income$36,040RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$36,040TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$336,230TotalRevenueColumnAmt
Related Or Exempt Func Income$36,040RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$342,134TotalAmt
Program Services$342,134ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,503TotalAmt
Program Services$525ProgramServicesAmt
Management And General$978ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,791TotalAmt
Program Services$23,223ProgramServicesAmt
Management And General$1,568ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$151,457TotalAmt
Program Services$138,003ProgramServicesAmt
Management And General$13,454ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,139TotalAmt
Program Services$3,139ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,505TotalAmt
Program Services$1,881ProgramServicesAmt
Management And General$624ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$14,600TotalAmt
Program Services$14,600ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,466TotalAmt
Program Services$6,466ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,497TotalAmt
Program Services$5,497ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$8,434TotalAmt
Program Services$7,169ProgramServicesAmt
Management And General$1,265ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$18,177$18,177
MISCELLANEOUS$4,524$3,932$592
DUES AND SUBSCRIPTIONS$641$583$58
REPAIRS AND MAINTENANCE$415$415

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$45TotalAmt
Program Services$38ProgramServicesAmt
Management And General$7ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$584,328TotalAmt
Program Services$565,782ProgramServicesAmt
Management And General$18,546ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$882,207BOYAmt
EOY$679,714EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$199,289BOYAmt
EOY$154,338EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,424BOYAmt
EOY$5,540EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,513LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$17,439LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,421BOYAmt
EOY$13,074EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,101,341BOYAmt
EOY$852,666EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$49,840BOYAmt
EOY$35,663EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$49,840BOYAmt
EOY$35,663EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$412,651BOYAmt
EOY$378,789EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$638,850BOYAmt
EOY$438,214EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,051,501BOYAmt
EOY$817,003EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,101,341BOYAmt
EOY$852,666EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$248,098ReconcilationRevenueExpnssAmt
Donated Services And Use Fclts$13,600DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,326,009CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$615,234CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$942,157CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$763,491CurrentTaxYearMinus1YearAmt
Current Tax Year$300,190CurrentTaxYearAmt
Total$4,947,081TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,326,009CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$615,234CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$942,157CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$763,491CurrentTaxYearMinus1YearAmt
Current Tax Year$300,190CurrentTaxYearAmt
Total$4,947,081TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$197,233SubstantialContributorsTotAmt
Public Support Total170$4,749,848PublicSupportTotal170Amt
Total Support$4,947,081TotalSupportAmt
Gross Receipts Rltd Activities$150,575GrossReceiptsRltdActivitiesAmt
Public Support CY1700.96010PublicSupportCY170Pct
Public Support PY1700.97980PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$30,513InvestmentCostOrOtherBasisAmt
Depreciation$17,439DepreciationAmt
Book Value$13,074BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,074TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$336,230TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$336,230RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$336,230TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$584,328TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$584,328ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$584,328TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationPART X, LINE 2: UNCERTAIN TAX POSITIONS- FIN 48 GUILFORD ADULT HEALTH, INC. IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE. AS OF AND DURING THE YEARS ENDED SEPTEMBER 30, 2014 AND 2013, THE AGENCY DID NOT RECOGNIZE A LIABILITY FOR ANY UNCERTAIN TAX POSITIONS. MANAGEMENTS DETERMINATION REGARDING THESE STANDARDS MAY BE SUBJECT TO REVIEW AND ADJUSTMENT AT A LATER DATE BASED ON FACTORS INCLUDING, BUT NOT LIMITED TO, AN ON-GOING ANALYSIS OF TAX LAWS, REGULATIONS AND INTERPRETATIONS THEREOF. NO EXAMINATIONS BY TAXING AUTHORITIES ARE IN PROGRESS. INFORMATION RETURNS FOR THE YEARS AFTER SEPTEMBER 30, 2010 REMAIN SUBJECT TO EXAMINATION.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1TRIAD ADULT & PEDIATRIC MEDICINEBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 S EUGENE STREETAddressLine1
CityGREENSBOROCity
StateNCState
ZIP Code27404ZIPCode
FieldValueIRS element (for citing)
Recipient EIN561991438RecipientEIN
Cash Grant$342,134CashGrantAmt
Purpose Of GrantPAYMENT OF WAGES AND BENEFITSPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6CONE HEALTH AND HIGH POINT REGIONAL RECEIVE ASSETS UPON DISSOLUTION
FORM 990, PART VI, SECTION A, LINE 7ACONE HEALTH AND HIGH POINT REGIONAL RECEIVE ASSETS UPON DISSOLUTION.
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF THE 990 WAS MADE AVAILABLE TO THE BOARD ALONG WITH THE FINANCIAL STATEMENTS FOR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED ANNUALLY BY EACH BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD REVIEWS THE PERFORMANCE OF THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS IN AN EFFORT TO DETERMINE HIS COMPENSATION. BOARD MEMBERS ARE FROM VARIOUS ORGANIZATIONS IN THE NONPROFIT INDUSTRY AND MEDICAL INDUSTRY. THEY COMPARE THE EXECUTIVE DIRECTOR'S COMPENSATION BASED ON THE COMPENSATION OF SIMILAR POSITIONS IN THEIR RESPECTIVE ORGANIZATIONS.
FORM 990, PART VI, SECTION C, LINE 18THE 990 IS MADE AVAILABLE ON PUBLIC WEBSITES, SUCH AS GUIDESTAR. IT IS ALSO AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS ARE ON FILE WITH THE EXECUTIVE DIRECTOR. INFORMATION IS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GGRANT WRITING & OTHER: PROGRAM SERVICE EXPENSES 120,268. MANAGEMENT AND GENERAL EXPENSES 13,454. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 133,722. AUDIT: PROGRAM SERVICE EXPENSES 10,372. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,372. CONSULTING FEES: PROGRAM SERVICE EXPENSES 7,363. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,363.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR .

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodePrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
CONE HEALTH SYSTEM
1200 N ELM STREETGREENSBORONC27401HOSPITALNC501(C)(3)170(B)(1)(A)(III)N/A0
HIGH POINT REGIONAL HOSPITAL
601 N ELM STREETHIGH POINTNC27261HOSPITALNC501(C)(3)170(B)(1)(A)(III)N/A0
TRIAD ADULT AND PEDIATRIC MEDICINE
1002 S EUGENE STREETGREENSBORONC27406HEALTHCARE PROVIDERNC501(C)(3)170(B)(1)(A)(III)N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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