MS COMPREHENSIVE CARE CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MS COMPREHENSIVE CARE CENTER (EIN 22-2402959)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201443189349307469
- Schema version
- 2013v3.1
- 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) |
|---|---|---|
| Return | 2014-11-14T14:59:02-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WithumSmithBrown PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 465 South St Ste 200 | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 079606497 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222402959 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MS COMPREHENSIVE CARE CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RYAN KENNEDY CPA | InCareOfNm |
| Business Name Control | MSCO | BusinessNameControlTxt |
| Phone | 2018337016 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | TEANECK | City |
| State | NJ | State |
| ZIP Code | 07666 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN KENNEDY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9738989494 | PhoneNum |
| Signature | 2014-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Scott Mariani | PreparerPersonNm |
| PTIN | P00642486 | PTIN |
| Phone | 9738989494 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL MARON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1 |
| City | TEANECK | City |
| State | NJ | State |
| ZIP Code | 07666 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $584,021 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOLYNAME.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT THE CHARITABLE PURPOSES OF HOLY NAME MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION REGARDING MS SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 20 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 48 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $208,408 | PYContributionsGrantsAmt |
| CY Contributions Grants | $131,656 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $295,419 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $402,086 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,753 | PYOtherRevenueAmt |
| CY Other Revenue | $5,003 | CYOtherRevenueAmt |
| PY Total Revenue | $508,580 | PYTotalRevenueAmt |
| CY Total Revenue | $538,745 | 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 | $686,625 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $845,512 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $131,003 | PYOtherExpensesAmt |
| CY Other Expenses | $213,226 | CYOtherExpensesAmt |
| PY Total Expenses | $817,628 | PYTotalExpensesAmt |
| CY Total Expenses | $1,058,738 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$309,048 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$519,993 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $293,067 | TotalAssetsBOYAmt |
| Total Assets EOY | $299,976 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,774,608 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,301,510 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,481,541 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$2,001,534 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SUPPORT THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HOLY NAME MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $952,865 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $402,086 | RevenueAmt |
| Desc | EXPENSES INCURRED IN SUPPORTING THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HOLY NAME MEDICAL CENTER SPECIFICALLY CENTERED ON MS SERVICES. HOLY NAME MEDICAL CENTER IS A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. | Desc |
| Total Program Service Expenses | $952,865 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | 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 | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 9 | 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 | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 20 | 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 | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN KENNEDY CPA | PersonNm |
| Phone | 2018337016 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 718 TEANECK ROAD | AddressLine1 |
| City | TEANECK | City |
| State | NJ | State |
| ZIP Code | 07666 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOSEPH FRASCINO MD | ||||||||
| CHAIRMAN - TRUSTEE | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DALE A CREAMER | ||||||||
| VICE CHAIRMAN - TRUSTEE | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SISTER BARBARA MORAN CSJP | ||||||||
| SECRETARY - TRUSTEE | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EDWIN H RUZINSKY CPA | ||||||||
| TREASURER - TRUSTEE | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH M LEMAIRE | ||||||||
| ASST SEC/ASST TREAS - TRUSTEE | 55.0 | Yes (X) | Yes (X) | $0 | $1,048,747 | $304,296 | ||
| ARNOLD BALSAM | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS BIRCH MD | ||||||||
| TRUSTEE - PRESIDENT MED STAFF | 55.0 | Yes (X) | Yes (X) | $0 | $144,863 | $21,791 | ||
| FRANK BRUNETTI | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT BRITZ | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID BUTLER MD | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| TED A CARNEVALE CPA | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| ARTHUR W CONWAY | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JOHN M GERAGHTY | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| SISTER ANNE HAYES | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID E LANDERS MD | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| SALVATORE LARAIA MD | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL LEBER | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL MARON | ||||||||
| TRUSTEE - PRESIDENT/CEO | 55.0 | Yes (X) | Yes (X) | $0 | $1,505,331 | $476,702 | ||
| SISTER ANTOINETTE MOORE CSJP | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JOSEPH PARISI JR | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| SISTER ANN RUTAN CSJP | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| SISTER ANN TAYLOR CSJP | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| LEON TEMIZ | ||||||||
| TRUSTEE | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MARY ANN PICONE MD | ||||||||
| MEDICAL DIRECTOR | 55.0 | $321,632 | $0 | $31,758 | Yes (X) | |||
| STACY MELVIN RN | ||||||||
| REGISTERED NURSE | 55.0 | $100,875 | $0 | $2,177 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $422,507 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,698,941 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $836,724 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Fundraising | $90,954 | FundraisingAmt |
| All Other Contributions | $40,702 | AllOtherContributionsAmt |
| Total Contributions | $131,656 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 541900 | $226,382 | $226,382 |
| OTHER HEALTHCARE RELATED REVENUE | 541900 | $175,704 | $175,704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $402,086 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $39,679 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $90,954 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $39,679 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $10,600 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $5,597 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,003 | TotalRevenueColumnAmt |
| Exclusion | $5,003 | ExclusionAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $538,745 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $402,086 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,003 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $353,390 | TotalAmt |
| Program Services | $318,051 | ProgramServicesAmt |
| Management And General | $35,339 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $369,064 | TotalAmt |
| Program Services | $332,157 | ProgramServicesAmt |
| Management And General | $36,907 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,452 | TotalAmt |
| Program Services | $4,008 | ProgramServicesAmt |
| Management And General | $444 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,738 | TotalAmt |
| Program Services | $65,464 | ProgramServicesAmt |
| Management And General | $7,274 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,868 | TotalAmt |
| Program Services | $41,281 | ProgramServicesAmt |
| Management And General | $4,587 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,007 | TotalAmt |
| Program Services | $35,106 | ProgramServicesAmt |
| Management And General | $3,901 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,080 | TotalAmt |
| Program Services | $10,872 | ProgramServicesAmt |
| Management And General | $1,208 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,347 | TotalAmt |
| Program Services | $11,112 | ProgramServicesAmt |
| Management And General | $1,235 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749 | TotalAmt |
| Program Services | $674 | ProgramServicesAmt |
| Management And General | $75 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,734 | TotalAmt |
| Program Services | $21,361 | ProgramServicesAmt |
| Management And General | $2,373 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,108 | TotalAmt |
| Program Services | $25,297 | ProgramServicesAmt |
| Management And General | $2,811 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PHYSICIAN FEES | $32,957 | $29,662 | $3,295 | $0 |
| MEDICAL SUPPLIES | $24,488 | $22,039 | $2,449 | |
| BILLING FEES | $13,439 | $12,095 | $1,344 | |
| PURCHASED SERVICES | $8,777 | $7,900 | $877 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,540 | TotalAmt |
| Program Services | $15,786 | ProgramServicesAmt |
| Management And General | $1,754 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058,738 | TotalAmt |
| Program Services | $952,865 | ProgramServicesAmt |
| Management And General | $105,873 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50 | BOYAmt |
| EOY | $50 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,224 | BOYAmt |
| EOY | $70,864 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,382 | BOYAmt |
| EOY | $29,622 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,120 | BOYAmt |
| EOY | $29,810 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $241,180 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $163,988 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,736 | BOYAmt |
| EOY | $77,192 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,555 | BOYAmt |
| EOY | $92,438 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $293,067 | BOYAmt |
| EOY | $299,976 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,401 | BOYAmt |
| EOY | $83,443 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,701,207 | BOYAmt |
| EOY | $2,218,067 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,774,608 | BOYAmt |
| EOY | $2,301,510 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,481,541 | BOYAmt |
| EOY | -$2,001,534 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,481,541 | BOYAmt |
| EOY | -$2,001,534 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $293,067 | BOYAmt |
| EOY | $299,976 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$519,993 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $368,596 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $424,401 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $335,927 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $208,408 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $131,656 | CurrentTaxYearAmt |
| Total | $1,468,988 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $390,359 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $369,501 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $441,822 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $295,419 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $402,086 | CurrentTaxYearAmt |
| Total | $1,899,187 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $758,955 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $793,902 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $777,749 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $503,827 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $533,742 | CurrentTaxYearAmt |
| Total | $3,368,175 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,368,175 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $758,955 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $793,902 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $777,749 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $503,827 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $533,742 | CurrentTaxYearAmt |
| Total | $3,368,175 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99991 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00009 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $241,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $163,988 | DepreciationAmt |
| Book Value | $77,192 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $77,192 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER RECEIVABLES | Desc |
| Book Value | $92,438 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $92,438 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $2,218,067 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,218,067 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FASHION SHOW | NameOfEvent1Amt |
| Gross Receipts Event1 | $130,633 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $90,954 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $39,679 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $23,424 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $7,300 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $8,955 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $130,633 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $90,954 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $39,679 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $23,424 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $7,300 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,955 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $39,679 | DirectExpenseSummaryEventsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | Yes (true) | 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOSEPH M LEMAIRE | ||||||||||||||
| ASST SEC/ASST TREAS - TRUSTEE | $0 | $766,750 | $0 | $250,000 | $0 | $31,997 | $0 | $280,005 | $0 | $24,291 | $0 | $1,353,043 | $0 | $0 |
| THOMAS BIRCH MD | ||||||||||||||
| TRUSTEE - PRESIDENT MED STAFF | $0 | $144,562 | $0 | $0 | $0 | $301 | $0 | $0 | $0 | $21,791 | $0 | $166,654 | $0 | $0 |
| MICHAEL MARON | ||||||||||||||
| TRUSTEE - PRESIDENT/CEO | $0 | $923,750 | $0 | $550,000 | $0 | $31,581 | $0 | $454,911 | $0 | $21,791 | $0 | $1,982,033 | $0 | $0 |
| MARY ANN PICONE MD | ||||||||||||||
| MEDICAL DIRECTOR | $320,227 | $0 | $0 | $0 | $1,405 | $0 | $10,200 | $0 | $21,558 | $0 | $353,390 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I; QUESTION 4B | THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2013 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOSEPH M. LEMAIRE, $269,805 AND MICHAEL MARON, $444,711. |
| SCHEDULE J, PART I; QUESTION 7 AND CORE FORM, PART VII | CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2013 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2013 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORE FORM, PART III | MS COMPREHENSIVE CARE CENTER IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. THE ORGANIZATION PROVIDES MULTIPLE SCLEROSIS SERVICES, RESEARCH AND EDUCATION. THE ORGANIZATION IS ALSO AFFILIATED WITH HOLY NAME MEDICAL CENTER, AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S MISSION SINCE INCEPTION IS TO PROVIDE COMPREHENSIVE AND HUMANE CARE TO PATIENTS WITH MULTIPLE SCLEROSIS AND THEIR FAMILIES. THE OVERALL GOAL OF CARE IS MAINTENANCE OF THE PATIENT'S HIGHEST LEVEL OF INDEPENDENCE IN THEIR HOME AND WORK ENVIRONMENT WHILE MAINTAINING SAFETY AND COMFORT. THE BERNARD GIMBEL MS CENTER OPENED IN 1985 AT HOLY NAME HOSPITAL AS AN INDEPENDENT ENTITY. THE CENTER WAS OPEN TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. THE STAFF THEN CONSISTED OF A NEUROLOGIST, A NURSE AND A VOLUNTEER. MEDICAL CARE CENTERED ON DIAGNOSIS AND SYMPTOMATIC MANAGEMENT ON AN OUTPATIENT BASIS. THE COMPREHENSIVE INTERDISCIPLINARY CARE MODEL INVOLVED MEDICAL, NURSING, REHAB, PSYCH-SOCIAL SUPPORT AND COORDINATED SERVICES FROM THE MS SOCIETY. THE OVERALL GOAL OF CARE WAS MAINTENANCE OF THE PATIENT'S HIGHEST LEVEL OF INDEPENDENCE IN THEIR HOME AND WORK ENVIRONMENT WHILE MAINTAINING SAFETY AND COMFORT. A VOLUNTEER RUN LENDING LIBRARY OF MS BOOKS AND VIDEOS WAS ORGANIZED AND READILY AVAILABLE TO ALL PATIENTS. IN THE 1990'S THE CENTER BECAME A RESEARCH SITE FOR MS DRUGS IN DEVELOPMENT. WITH THE ADVENT OF FDA APPROVED SELF INJECTABLE IMMUNOMODULATING THERAPIES, MANAGEMENT OF MS PATIENTS BECAME MORE COMPLEX. THE NEED FOR ANCILLARY SUPPORT SYSTEMS WAS RECOGNIZED BY THE DRUG COMPANIES WHO CREATED FINANCIAL AND NURSING SUPPORT TEAMS TO HELP PATIENTS BY PHONE OR IN THE HOME. PATIENTS RECEIVED EVER BROADENING EDUCATION FROM BOTH THE CENTER STAFF AND MS SOCIETY OUTREACH AND PUBLICATIONS ADDRESSING THE WIDE RANGING NEEDS OF MS PATIENTS. SELF INJECTION TECHNIQUE AND ADHERENCE TO THERAPY QUICKLY BECAME AN EDUCATION PRIORITY FOR THE NURSING STAFF. TEACHING WAS DONE BOTH INDIVIDUALLY AND IN GROUPS. THE CENTER CLINICAL STAFF GREW TO FOUR NEUROLOGISTS (PART TIME), TWO NURSE PRACTIONERS AND FOUR PART TIME RNS. IN 1997 THE IOMSN (INTERNAT'L ORGANIZATION OF MS NURSES) WAS ORGANIZED, IN WHICH ALL CENTER NURSES ARE MEMBERS. A HIGHLIGHT DURING THIS ERA WAS THE MONTHLY TEAM MEETING WHICH ENCOMPASSED MEDICAL, NURSING, SOCIAL WORK, HOME CARE AND REHAB STAFF WHO DISCUSSED ALL ASPECTS OF SELECT PATIENT CASES. ANOTHER COMPLEX MODALITY THAT EMERGED AT THIS TIME WAS THE INTRATHECAL BACLOFEN PUMP. THIS SURGICALLY IMPLANTED PUMP DELIVERS MEDICATION TO RELIEVE SPASTICITY WHICH CAN BE DISABLING. WE TEAMED UP WITH A SPECIALIZED HOME INFUSION AGENCY WHICH CONTINUES TO PROVIDE EXPERTISE AND INDIVIDUALIZED HOME CARE TO THESE PATIENTS. MEDICAL AND NURSING MANAGEMENT OF THESE PATIENTS TAKES A HIGH LEVEL OF SPECIALIZED KNOWLEDGE AND COMMUNICATION SKILL. STARTING IN 2000 MORE COMPLEX MEDICATIONS WERE PROVEN TO DELAY DISABILITY AND SLOW PROGRESSION OF MS. THESE INCLUDED CHEMOTHERAPY AND, EVENTUALLY, MONOCLONAL THERAPIES. WITH THE INCREASE IN EFFICACY CAME INCREASED SIDE EFFECTS AND RISKS WHICH NECESSITATED INCREASED VIGILANCE AND MONITORING BY THE MEDICAL AND NURSING STAFF. AS A RESULT WE EXPANDED OUR "TEAM" TO INCLUDE ONCOLOGY DOCTORS AND NURSES TO HELP MANAGE OUR INFUSION PATIENTS. THE CENTER STAFF QUICKLY ATTAINED THE KNOWLEDGE REQUIRED TO TEACH AND SUPPORT THE PATIENTS WHO GRAVITATED TO THIS CENTER IN ORDER TO GET STATE OF THE ART TREATMENT FOR THEIR DISEASE. DRUG COMPANY REPRESENTATIVES VISITED FREQUENTLY TO OFFER SUPPORT TO STAFF WITH MEDICAL UPDATES AND PATIENT SUPPORT SYSTEMS. IN 2006 THE MS COMPREHENSIVE CARE CENTER (FORMERLY KNOWN AS THE BERNARD GIMBEL MS CENTER) BECAME A PART OF HOLY NAME MEDICAL CENTER. BY THE END OF 2010 THE FIRST ORAL THERAPY IN MS WAS APPROVED AND COMMERCIALLY AVAILABLE. THIS DRUG IS PROVEN SAFE AND EFFECTIVE BUT CARRIES RISKS THAT REQUIRE PATIENT INVOLVEMENT IN ONGOING TESTING AND MONITORING. THE FDA HAS MANDATED THAT THE FIRST DOSE OF THIS MEDICATION BE ADMINISTERED IN A MEDICAL SETTING WITH SIX HOURS OF VITAL SIGN MONITORING WHICH IS PROVIDED ON SITE. PATIENT SCREENING FOR THIS MEDICATION AND ONGOING TESTING REQUIRES NURSING CASE MANAGEMENT. A SECOND ORAL MEDICATION WAS APPROVED IN THE CLOSURE OF 2012, WITH A THIRD EMERGING IN EARLY 2013. EMPHASIS ON DILIGENT PATIENT CARE MANAGEMENT BECAME THE PRIMARY FOCUS. ALL OF THE APPROVED THERAPIES ARE USED IN OUR PRACTICE. WHEELCHAIR CLINIC CONTINUES ON A MONTHLY BASIS; WEEKLY MS EXERCISE CLASS, MS PATIENT SUPPORT GROUPS, NEWLY DIAGNOSED PATIENT GROUP (LED BY MD)AND INTERMITTENT EDUCATIONAL SEMINARS. USE OF ALL HNMC SERVICES BY OUR PATIENTS IS PREFERRED. THEY ARE FREQUENT USERS OF REHAB, INFUSION, LAB, MRI AND IN PATIENT SERVICES. BY JUNE 2012 THE CENTER CLINICAL STAFF CONSISTED OF ONE NEUROLOGIST, TWO STAFF NURSES, ONE RESEARCH NURSE AND ONE PART TIME NEUROPSYCHOLOGIST. THE NURSES ARE MS CERTIFIED BY THE IOMSN. WE CONTINUE TO PURSUE THE ORIGINAL MISSION OF COMPREHENSIVE AND HUMANE CARE TO PATIENTS WITH MULTIPLE SCLEROSIS AND THEIR FAMILIES. THIS CENTER CONTINUES TO BE A MODEL OF COMPREHENSIVE TERTIARY CARE FOR MS PATIENTS AND IS KNOWN WORLD WIDE. OUR FUTURE PLANS FOR 2013 INCLUDE TWO PART-TIME NEUROLOGISTS AND ONE FULL-TIME NEUROLOGIST. ALSO, IN 2013 WE PLAN TO INCLUDE A PART-TIME IN OFFICE SOCIAL WORKER AND DO MORE PATIENT EDUCATION PROGRAMS. FUNDRAISING THERE HAVE BEEN A VARIETY OF FUNDRAISING EVENTS THAT HAVE BEEN COORDINATED IN THE PAST SUCH AS AN ANNUAL FASHION SHOW, GOLF OUTINGS, WALK-A-THONS, AND A CLASSICAL CONCERT. WE CONTINUE TO SEEK SUPPORT THROUGH GRANTS, CORPORATE MATCHING GIFTS AND CORPORATE SOLICITATION TO HELP SUPPORT OUR MISSION. IN THE FALL OF 2011, THE MS CENTER HELD ITS FIRST AWARDS DINNER IN WHICH WE RECOGNIZED INSPIRATIONAL PATIENTS, VOLUNTEER LEADERS AND ADVOCATES WHO ARE THE "FACE" OF THE MS CENTER AND EXHIBIT COURAGE AND DETERMINATION IN THE FIGHT AGAINST MS. RESEARCH IN CONJUNCTION WITH MEDICAL CARE TO MS PATIENTS HISTORICALLY, NURSING RESEARCH BEGAN AT THE CENTER IN THE 1980'S, WITH USE OF ANTIDEPRESSANTS AND BLADDER MANAGEMENT MEDICATIONS FOR THE MS PATIENT. EFFORTS AT THAT TIME WERE SYMPTOM MANAGEMENT BASED, UNTIL THE DEVELOPMENT OF DISEASE MODIFYING THERAPIES (DMT'S) EMERGED. THE FIRST GENERATION OF INJECTABLE DMT'S BECAME AVAILABLE IN THE 1990'S, WITH THE APPROVAL OF BETASERON, AVONEX AND COPAXONE. THE PRIMARY FOCUS WAS ON THE RELAPSING REMITTING POPULATION. THE CENTER BEGAN ITS INVOLVEMENT AT THIS TIME WITH THE USE OF BETASERON IN THE SECONDARY PROGRESSIVE POPULATION IN THE LATE 90'S, HEAD TO HEAD STUDIES WITH APPROVED THERAPIES, AND EMERGING INTRAVENOUS THERAPIES SUCH AS NATALIZUMAB (TYSABRI), IN THE EARLY 2000'S. THIS IS CONSIDERED THE SECOND GENERATION OF MS TREATMENT. SMALLER SCALE STUDIES INVOLVED IMPROVEMENT OF RELAPSE MANAGEMENT, AND USE OF GENERIC SUSTAINED RELEASE MEDICATIONS. CURRENTLY, THE CENTER'S PROVISION OF CARE TO MS PATIENTS INVOLVES BOTH THE INFLAMMATORY AND NEURO DEGENERATIVE PROCESS OF MS. NEW AND EMERGING THIRD GENERATION OF DISEASE MODIFYING THERAPIES INVOLVE ORAL MEDICATION, NEW FORMULATIONS OF EXISTING DMT'S, COMBINATION THERAPIES, AND OTHER MONOCLONAL THERAPIES. RESEARCH HAS INVOLVED NOT ONLY IMPROVING TREATMENT OPTIONS FOR THE RELAPSING REMITTING MS PATIENT, BUT HAS EXPANDED INTO.DEVELOPMENT OF EFFECTIVE THERAPIES FOR THE PROGRESSIVE FORMS OF THE DISEASE. THE MAJORITY OF THE CURRENT RESEARCH EFFORTS HAS BEEN FOCUSED IN THIS AREA. COLLABORATIVE EFFORTS WITH THE RESEARCHERS AT ROBERT WOOD JOHNSON IN DEVELOPMENT OF BIOMARKERS TO ASSESS RISK FOR PREDISPOSITION TO MS WAS ONGOING. INVOLVEMENT WITH TESTING FOR ANTIBODY PRESENCE TO ASSESS RISK POTENTIAL IN TYSABRI PATIENTS HAS ALSO BEEN ONGOING. THE CENTER CONTINUES TO BE A MODEL OF COMPREHENSIVE TERTIARY CARE FOR MS PATIENTS AND IS KNOWN WORLD WIDE. ANNUALLY, THE ORGANIZATION SERVES OVER 2,000 PATIENTS WITH MS. THE ORGANIZATION HAS A CLINICAL AFFILIATION WITH THE NATIONAL MS SOCIETY. |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | HOLY NAME MEDICAL CENTER ("HNMC") IS THE SOLE MEMBER OF THIS ORGANIZATION. HNMC HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. |
| CORE FORM, PART VI, SECTION B; QUESTION 11B | THE ORGANIZATION IS AN AFFILIATE OF AND CONTROLLED BY HOLY NAME MEDICAL CENTER ("HNMC"). THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION THE ORGANIZATION'S AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL INCLUDING THE CHIEF FINANCIAL OFFICER, DIRECTOR OF ACCOUNTING AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. A MEETING WAS ALSO HELD TO REVIEW THE FINAL DRAFT OF THE FEDERAL FORM 990 WITH HNMC'S AUDIT COMMITTEE FOR REVIEW AND APPROVAL. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING OF THE TAX RETURN WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION IS AN AFFILIATE OF AND CONTROLLED BY HOLY NAME MEDICAL CENTER ("HNMC"). THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION AND THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER PRESENTS THIS SUMMARY TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION IS AN AFFILIATE OF AND CONTROLLED BY HOLY NAME MEDICAL CENTER ("HNMC"). HNMC'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF HNMC'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. CERTAIN HNMC SENIOR MANAGEMENT PERSONNEL, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFCIER AND EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER ALSO SERVE AS OFFICERS OF THIS ORGANIZATION. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. |
| CORE FORM, PART VII AND SCHEDULE J | PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR THE RELATED ORGANIZATION; NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART VII, SECTION A, COLUMN B | CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER RELATED AFFILIATES. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF ALL RELATED ORGANIZATIONS AND THIS ORGANIZATION, IN TOTAL. |
| CORE FORM, PART XII; QUESTION 2 | AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HOLY NAME MEDICAL CENTER, INC. AND AFFILIATES, FOR THE YEARS ENDED DECEMBER 31, 2013 AND DECEMBER 31, 2012; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. HOLY NAME MEDICAL CENTER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE AUDITED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HOLY NAME HEALTH CARE FOUNDATION | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 222737143 | FUNDRAISING | NJ | 501(C)(3) | 509(A)(3) | HNMC | false |
| HOLY NAME REAL ESTATE CORP | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223412504 | PROPERTY CO | NJ | 501(C)(3) | 509(a)(3) | HNMC | false |
| SISTERS OF ST JOSEPH OF PEACE | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223412084 | RELIGIOUS ORD | NJ | 501(C)(3) | 170B1AI | NA | false |
| HOLY NAME MEDICAL CENTER | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 221487322 | HEALTHCARE | NJ | 501(C)(3) | HOSPITAL | SSP | false |
| HOLY NAME EMS INC | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 270294681 | HEALTHCARE | NJ | 501(C)(3) | 509(A)(3) | HNMC | false |
| THE CRUDEM FOUNDATION INC | ||||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 431660199 | HEALTHCARE | MO | 501(C)(3) | 509(A)(1) | HNMC FDN | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTH PARTNERS SERVICES INC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223618636 | MGMT SERVICES | NJ | NA | C CORP. | false |
| PEACE HEALTH PARTNERS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223618634 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| HOUSE PHYSICIANS PARTNERS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223808427 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| HEMATOLOGYONCOLOGY PHYSICIANS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 223808421 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| RIVERSIDE FAMILY CARE | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 200446233 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| RADIATION ONCOLOGY PARTNERS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 201104758 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| EXCELCARE MEDICAL ASSOCIATES | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 203130405 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| BREAST IMAGING PARTNERS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 753226059 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| HOLY NAME CARDIOLOGY ASSOCIATES PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 753226063 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| BREAST CARE PARTNERS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 113787403 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| HOLY NAME PULMONARY ASSOCIATES PC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 830511119 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| WOMEN'S CLINIC PARTNERS | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 364635222 | HLTHCARE SVCS | NJ | NA | C CORP. | false |
| MULKAY CARDIOLOGY CONSULTANTS AT HNMC | |||||||||
| 718 TEANECK ROAD | TEANECK | NJ | 07666 | 463392343 | HLTHCARE SVCS | NJ | C CORP. | false | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY NAME MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | E | TransactionTypeTxt |
| Involved | $516,859 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V | FormAndLineReferenceDesc |
| Explanation | HOLY NAME MEDICAL CENTER ROUTINELY PAYS EXPENSES FOR VARIOUS RELATED AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED. | ExplanationTxt |
Comments