GUILFORD ADULT HEALTH INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- GUILFORD ADULT HEALTH INC (EIN 04-3726317)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-03-31
- IRS object ID
- 201400909349300300
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-03-31T07:42:02-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561146197 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHARRARD MCGEE & CO PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 10439 | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 274040439 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043726317 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GUILFORD ADULT HEALTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GUIL | NameControl |
| Phone | 3365559700 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 S EUGENE STREET | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27406 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MS LISA DUCK | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 3365559700 | Phone |
| Date Signed | 2014-03-28 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | J CLARK BECK | Name |
| PTIN | P00743158 | PTIN |
| Phone | 3362729777 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | MS LISA DUCK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 S EUGENE STREET | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27406 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 784816 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GUILFORDCCN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 942157 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 763491 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 32300 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 21325 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 974457 | TotalRevenuePriorYear |
| Total Revenue Current Year | 784816 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 456932 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 972128 | OtherExpensePriorYear |
| Other Expenses Current Year | 337033 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 972128 | TotalExpensesPriorYear |
| Total Expenses Current Year | 793965 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2329 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -9149 | RevenuesLessExpensesCY |
| Total Assets BOY | 1103399 | TotalAssetsBOY |
| Total Assets EOY | 1140608 | TotalAssetsEOY |
| Total Liabilities BOY | 100362 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 49840 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1003037 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1090768 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDE LONG-TERM SECURE FUNDING FOR INDIGENT CARE AND BE AN ADVOCATE FOR THE COMMUNITY AND CLIENTS SERVED BY CLINICS IN THE AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 768593 | Expense |
| Grants | 456932 | Grants |
| Revenue | 21325 | Revenue |
| Description | 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. | Description |
| Total Program Service Expense | 768593 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 10 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 0 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA MCKOY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3363559699 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5817 HIGH POINT ROAD | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27407 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| LISA DUCK | ||||||
| EXECUTIVE DIRECTOR | 20.00 | X | X | 0 | 69205 | 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/TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| LINDA RONEY | ||||||
| CHAIRPERSON | 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 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 69205 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 75000 | GovernmentGrants |
| All Other Contributions | 688491 | AllOtherContributions |
| Total Contributions | 763491 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SERVICE REVENUE | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 21325 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21325 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 21325 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 784816 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21325 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 456932 | Total |
| Program Services | 456932 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1711 | Total |
| Program Services | 957 | ProgramServices |
| Management And General | 754 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26806 | Total |
| Program Services | 19291 | ProgramServices |
| Management And General | 7515 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 248964 | Total |
| Program Services | 236757 | ProgramServices |
| Management And General | 12207 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1124 | Total |
| Program Services | 1124 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14827 | Total |
| Program Services | 12603 | ProgramServices |
| Management And General | 2224 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13001 | Total |
| Program Services | 13001 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1457 | Total |
| Program Services | 1457 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2685 | Total |
| Program Services | 2685 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9140 | Total |
| Program Services | 6902 | ProgramServices |
| Management And General | 2238 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 12957 | 12957 | |
| DUES AND SUBSCRIPTIONS | 2014 | 1962 | 52 |
| MISCELLANEOUS | 1939 | 1599 | 340 |
| TELEPHONE | 280 | 238 | 42 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 128 | Total |
| Program Services | 128 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 793965 | Total |
| Program Services | 768593 | ProgramServices |
| Management And General | 25372 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 820781 | BOY |
| EOY | 882207 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 272404 | BOY |
| EOY | 238556 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3900 | BOY |
| EOY | 4424 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 27362 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 11941 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6314 | BOY |
| EOY | 15421 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103399 | BOY |
| EOY | 1140608 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100362 | BOY |
| EOY | 49840 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100362 | BOY |
| EOY | 49840 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 229303 | BOY |
| EOY | 412651 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 773734 | BOY |
| EOY | 678117 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1003037 | BOY |
| EOY | 1090768 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1103399 | BOY |
| EOY | 1140608 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -9149 | ReconcilationRevenueExpenses |
| Reconcilation Donated Services | 19880 | ReconcilationDonatedServices |
| Reconcilation Other Changes | 77000 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2715646 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2326009 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 615234 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 942157 | CurrentTaxYearMinus1Year |
| Current Tax Year | 763491 | CurrentTaxYear |
| Total | 7362537 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2715646 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2326009 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 615234 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 942157 | CurrentTaxYearMinus1Year |
| Current Tax Year | 763491 | CurrentTaxYear |
| Total | 7362537 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 148924 | AmountsSubstContributorsTotal |
| Public Support Total170 | 7213613 | PublicSupportTotal170 |
| Total Support | 7362537 | TotalSupport |
| Gross Receipts From Admissions Etc | 131133 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.97980 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.96770 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 27362 | InvestmentCostOrOtherBasis |
| Depreciation | 11941 | Depreciation |
| Book Value | 15421 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 15421 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 804696 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 19880 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 19880 | RevenueNotRptdF990 |
| Revenue Subtotal | 784816 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 784816 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 793965 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 793965 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 793965 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | 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, 2013 AND 2012, 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, 2009 REMAIN SUBJECT TO EXAMINATION. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRIAD ADULT & PEDIATRIC MEDICINE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 S EUGENE STREET | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27404 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 561991438 | EINOfRecipient |
| Amount Of Cash Grant | 456932 | AmountOfCashGrant |
| Purpose Of Grant | PAYMENT OF WAGES AND BENEFITS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 1,637. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,637. AUDIT : PROGRAM SERVICE EXPENSES 6,781. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,781. CONSULTING FEES : PROGRAM SERVICE EXPENSES 26,035. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,035. CONTRACT LABOR : PROGRAM SERVICE EXPENSES 176,024. MANAGEMENT AND GENERAL EXPENSES 12,207. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 188,231. PATIENT CARE EXPENSES: PROGRAM SERVICE EXPENSES 26,280. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,280. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | CHANGES IN NET ASSETS- MEMBER CONTRIBUTIONS 77,000. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR . |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| CONE HEALTH SYSTEM | |||||||||
| 1200 N ELM STREET | GREENSBORO | NC | 27401 | HOSPITAL | NC | 501(C)(3) | 170(B)(1)(A)(III) | NA | 0 |
| HIGH POINT REGIONAL HOSPITAL | |||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | HOSPITAL | NC | 501(C)(3) | 170(B)(1)(A)(III) | NA | 0 |
| TRIAD ADULT AND PEDIATRIC MEDICINE | |||||||||
| 1002 S EUGENE STREET | GREENSBORO | NC | 27406 | HEALTHCARE PROVIDER | NC | 501(C)(3) | 170(B)(1)(A)(III) | NA | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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