2015-04-08T15:40:33-05:00 2014-09-30 561146197 SHARRARD MCGEE & CO PA PO BOX 10439 GREENSBORO NC 274040439 990 2013-10-01 043726317 GUILFORD ADULT HEALTH INC GUIL 3365559700 1002 S EUGENE STREET GREENSBORO NC 27406 MS LISA DUCK EXECUTIVE DIRECTOR 3365559700 2015-03-31 1 DENNIS A NEWMAN P01221886 3362729777 2013 2016-02-25 16:41:14Z MS LISA DUCK 1002 S EUGENE STREET GREENSBORO NC 27406 336230 0 X WWW.GUILFORDCCN.ORG X 2002 NC TO PROVIDE ACCESSIBLE, AFFORDABLE, AND QUALITY MEDICAL AND DENTAL SERVICES TO GUILFORD COUNTY RESIDENTS WITH INCOMES BETWEEN 0% AND 200% OF THE FEDERAL POVERTY LEVEL. 10 10 0 0 0 0 763491 300190 21325 36040 0 0 0 0 784816 336230 456932 342134 0 0 0 0 0 0 0 337033 242194 793965 584328 -9149 -248098 1101341 852666 49840 35663 1051501 817003 PROVIDE LONG-TERM SECURE FUNDING FOR INDIGENT CARE AND BE AN ADVOCATE FOR THE COMMUNITY AND CLIENTS SERVED BY CLINICS IN THE AREA. 0 0 565782 342134 36040 GUILFORD 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. 565782 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DESHANDRA WOODLE 3363559696 1002 S EUGENE STREET GREENSBORO NC 27406 LISA DUCK EXECUTIVE DIRECTOR 20.00 X X 73550 0 0 MERLE GREEN BOARD MEMBER 1.00 X 0 0 0 PATRICIA A SOENKSEN BOARD MEMBER 1.00 X 0 0 0 TIM CLONTZ VICE CHAIRPERSON/SECRETARY 1.00 X X 0 0 0 CHESTER BROWN III BOARD MEMBER 1.00 X 0 0 0 ANGIE ORTH BOARD MEMBER 1.00 X 0 0 0 MARTY LAWING BOARD MEMBER 1.00 X 0 0 0 CARIN HIOTT BOARD MEMBER 1.00 X 0 0 0 BRIAN ELLERBY EX-OFFICIO 1.00 X 0 0 0 DENISE POTTER BOARD MEMBER 1.00 X 0 0 0 AASHKA MEHTA BOARD MEMBER 1.00 X 0 0 0 73550 0 0 0 0 0 0 0 19230 280960 300190 SERVICE REVENUE 624100 36040 36040 36040 336230 36040 0 0 X 342134 342134 1503 525 978 24791 23223 1568 151457 138003 13454 3139 3139 2505 1881 624 14600 14600 6466 6466 5497 5497 8434 7169 1265 MEDICAL SUPPLIES 18177 18177 MISCELLANEOUS 4524 3932 592 DUES AND SUBSCRIPTIONS 641 583 58 REPAIRS AND MAINTENANCE 415 415 45 38 7 584328 565782 18546 0 882207 679714 199289 154338 4424 5540 30513 17439 15421 13074 1101341 852666 49840 35663 49840 35663 X 412651 378789 638850 438214 1051501 817003 1101341 852666 -248098 13600 0 X X 0 1 X 1 0 X 2326009 615234 942157 763491 300190 4947081 2326009 615234 942157 763491 300190 4947081 197233 4749848 4947081 150575 0.96010 0.97980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 30513 17439 13074 13074 X 336230 0 336230 0 336230 584328 0 584328 0 584328 PART X, LINE 2: PART 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. 0 TRIAD ADULT & PEDIATRIC MEDICINE 1002 S EUGENE STREET GREENSBORO NC 27404 561991438 342134 PAYMENT OF WAGES AND BENEFITS FORM 990, PART VI, SECTION A, LINE 6 CONE HEALTH AND HIGH POINT REGIONAL RECEIVE ASSETS UPON DISSOLUTION FORM 990, PART VI, SECTION A, LINE 7A CONE HEALTH AND HIGH POINT REGIONAL RECEIVE ASSETS UPON DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE 990 WAS MADE AVAILABLE TO THE BOARD ALONG WITH THE FINANCIAL STATEMENTS FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED ANNUALLY BY EACH BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 15 THE 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 18 THE 990 IS MADE AVAILABLE ON PUBLIC WEBSITES, SUCH AS GUIDESTAR. IT IS ALSO AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE ON FILE WITH THE EXECUTIVE DIRECTOR. INFORMATION IS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G GRANT 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 . CONE HEALTH SYSTEM 1200 N ELM STREET GREENSBORO NC 27401 HOSPITAL NC 501(C)(3) 170(B)(1)(A)(III) N/A 0 HIGH POINT REGIONAL HOSPITAL 601 N ELM STREET HIGH POINT NC 27261 HOSPITAL NC 501(C)(3) 170(B)(1)(A)(III) N/A 0 TRIAD ADULT AND PEDIATRIC MEDICINE 1002 S EUGENE STREET GREENSBORO NC 27406 HEALTHCARE PROVIDER NC 501(C)(3) 170(B)(1)(A)(III) N/A 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0