NEIGHBORHOOD HEALTH CLINICS INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NEIGHBORHOOD HEALTH CLINICS INC (EIN 35-1922483)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-09-12
- IRS object ID
- 201312559349300701
- 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 | 2013-09-12T08:00:05-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 West Madison Street | AddressLine1 |
| Address Line2 | Suite 700 | AddressLine2 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 606024903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351922483 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEIGHBORHOOD HEALTH CLINICS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NEIG | NameControl |
| Phone | 2604582648 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 South Calhoun Street | AddressLine1 |
| City | Fort Wayne | City |
| State | IN | State |
| ZIP Code | 46802 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY S HAUPERT | Name |
| Title | PRESIDENT/CEO | Title |
| Date Signed | 2013-04-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Nicole Bencik | Name |
| PTIN | P00756195 | PTIN |
| Phone | 3128997000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY HAUPERT | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 South Calhoun Street | AddressLine1 |
| City | Fort Wayne | City |
| State | IN | State |
| ZIP Code | 46802 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12956912 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NHCI.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | NEIGHBORHOOD HEALTH CLINICS OFFERS AN ARRAY OF HEALTH CARE SERVICES, INCLUDING FULL FAMILY MEDICAL AND DENTAL CARE, PEDIATRIC CARE, WOMEN'S HEALTH CARE, PREGNANCY CARE, AND THE WIC NUTRITIONAL SUPPLEMENT PROGRAM TO LOW AND MODERATE INCOME FAMILIES IN THE FORT WAYNE, INDIANA AND SURROUNDING AREAS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 21 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 21 | NbrIndependentVotingMembers |
| Total Nbr Employees | 202 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 6737588 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 9076484 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3287680 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3869667 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3125 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2561 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1074 | OtherRevenuePriorYear |
| Other Revenue Current Year | 8200 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10029467 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12956912 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5882111 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5873407 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 68059 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3324430 | OtherExpensePriorYear |
| Other Expenses Current Year | 3266092 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9206541 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9139499 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 822926 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3817413 | RevenuesLessExpensesCY |
| Total Assets BOY | 4563391 | TotalAssetsBOY |
| Total Assets EOY | 9246143 | TotalAssetsEOY |
| Total Liabilities BOY | 821173 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1686512 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3742218 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7559631 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE PURPOSE OF NEIGHBORHOOD HEALTH CLINICS, INC. (NHCI) IS TO IDENTIFY THE NEEDS OF AND TO PROVIDE QUALITY COMPREHENSIVE HEALTH SERVICES TO THOSE PERSONS UNABLE TO ACCESS THE NORMAL HEALTH CARE DELIVERY SYSTEMS. THIS IS TO BE DONE IN AN EFFECTIVE MANNER WITH RESPECT AND SENSITIVITY TO THOSE BEING SERVED. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 8238173 | Expense |
| Grants | 0 | Grants |
| Revenue | 3869667 | Revenue |
| Description | NEIGHBORHOOD HEALTH CLINICS, INC. (NHCI) PROVIDES QUALITY COMPREHENSIVE CARE, INCLUDING MEDICAL AND DENTAL SERVICES, TO INDIVIDUALS WHO ARE UNABLE TO ACCESS THE NORMAL HEALTH CARE SYSTEM. NHCI'S MAIN OFFICE IS LOCATED IN A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA WHERE FEW OTHER MEDICAL/DENTAL SERVICES ARE AVAILABLE. DURING 2012, NHCI PROVIDED MEDICAL SERVICES TO 11,407 INDIVIDUALS AND DENTAL SERVICES TO 5,955 INDIVIDUALS. OF THE INDIVIDUALS SERVED, 60% WERE AT OR BELOW THE POVERTY LEVEL; 34% WERE MINORITIES; AND 95% WERE EITHER MEDICARE/MEDICAID RECIPIENTS OR WERE UNINSURED. AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), NHCI PROVIDES SERVICES TO QUALIFIED INDIVIDUALS ON A SLIDING FEE SCALE BASED ON THEIR ABILITY TO PAY; DURING 2012 NHCI PROVIDED A TOTAL OF $2,773,817 IN DISCOUNTED SERVICES. (CONTINUED IN SCHEDULE O) | Description |
| Total Program Service Expense | 8238173 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 202 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 21 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 21 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Richard Yergler | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2604582648 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 South Calhoun Street | AddressLine1 |
| City | Fort Wayne | City |
| State | IN | State |
| ZIP Code | 46802 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BRUCE LEHMAN | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| J PHILLIP TYNDALL MD | |||||||
| 1ST VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| JAMES FISHER | |||||||
| 2ND VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| JOE COHEN | |||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| MIKE ZIEMBO | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| ALICE MULL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ANGELA RUIZ | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| CYNTHIA AMBER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DANIEL PASCHALL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DENNIS BECKER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DONNA SPINA | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| HAROUT KOUYOUMDJIAN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| HOLLI SEABURY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JOHN WALSH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JOSEPH O'DELL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| KRISHNA JO MARTIN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| NANETTE BAKER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PATRICIA JETER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| SUE EHINGER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TERRY BROBERG-SWANGIN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TOMEKA GRIMES | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ANGIE ZAEGAL | |||||||
| COO | 40.00 | X | 60783 | 0 | 2166 | ||
| JOY SLOAN | |||||||
| VP/CFO (THROUGH 12/21/12) | 40.00 | X | 61239 | 0 | 23478 | ||
| MARY S HAUPERT | |||||||
| PRESIDENT/CEO | 40.00 | X | 94158 | 0 | 18047 | ||
| RICHARD YERGLER | |||||||
| VP/CFO (12/24 - 12/31/2012) | 40.00 | X | 11939 | 0 | 2159 | ||
| TERRELL BOND | |||||||
| VP/CMO | 40.00 | X | 177031 | 0 | 19076 | ||
| CAROLYN YAP | |||||||
| PHYSICIAN | 40.00 | 164444 | 0 | 7055 | X | ||
| DR MICHAEL DUCH | |||||||
| DENTAL DIRECTOR | 32.00 | 107757 | 0 | 17690 | X | ||
| PATRICK QUINN | |||||||
| DENTIST | 40.00 | 120719 | 0 | 5939 | X | ||
| PIYUSH KUMAR | |||||||
| PHYSICIAN | 40.00 | 162555 | 0 | 11932 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 960625 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 107542 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| FETTERS CONSTRUCTION INC | |||||
| 5417 COUNTY ROAD 427 | AUBURN | IN | 46706 | CONSTRUCTION LABOR | 356203 |
| PARKVIEW HOSPITAL | |||||
| 2200 RANDALLIA DRIVE | FORT WAYNE | IN | 46805 | LABORATORY SERVICES | 236363 |
| PRIORITY MANAGEMENT GROUP | |||||
| 700 SCHOOL STREET | PAWTUCKET | RI | 02860 | ACCTS RECEIVABLE/BILLING SERVICE | 143343 |
| MAINSTAY SOLUTIONS | |||||
| PO BOX 15562 | FORT WAYNE | IN | 46885 | IT SERVICE | 122961 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Federated Campaigns | 156200 | FederatedCampaigns |
| Government Grants | 8252032 | GovernmentGrants |
| All Other Contributions | 668252 | AllOtherContributions |
| Noncash Contributions | 308044 | NoncashContributions |
| Total Contributions | 9076484 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 623000 | 3869667 | 3869667 |
| 0 | |||
| 0 | |||
| 0 | |||
| 0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3869667 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2561 | TotalRevenueColumn |
| Exclusion | $2,561 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3121 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3121 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3121 | TotalRevenueColumn |
| Exclusion | $3,121 | ExclusionAmount |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS | 900099 | 5079 | $5,079 |
| 0 | |||
| 0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5079 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12956912 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3869667 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $10,761 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 443478 | Total |
| Program Services | 395359 | ProgramServices |
| Management And General | 43323 | ManagementAndGeneral |
| Fundraising | 4796 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4512403 | Total |
| Program Services | 4016614 | ProgramServices |
| Management And General | 446394 | ManagementAndGeneral |
| Fundraising | 49395 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 545964 | Total |
| Program Services | 492568 | ProgramServices |
| Management And General | 48055 | ManagementAndGeneral |
| Fundraising | 5341 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 371562 | Total |
| Program Services | 322796 | ProgramServices |
| Management And General | 43889 | ManagementAndGeneral |
| Fundraising | 4877 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12143 | Total |
| Program Services | 1673 | ProgramServices |
| Management And General | 10470 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54470 | Total |
| Program Services | 53238 | ProgramServices |
| Management And General | 1232 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 741365 | Total |
| Program Services | 727076 | ProgramServices |
| Management And General | 14289 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 224525 | Total |
| Program Services | 188075 | ProgramServices |
| Management And General | 32800 | ManagementAndGeneral |
| Fundraising | 3650 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74109 | Total |
| Program Services | 69458 | ProgramServices |
| Management And General | 4651 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 776481 | Total |
| Program Services | 729199 | ProgramServices |
| Management And General | 47282 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49220 | Total |
| Program Services | 45790 | ProgramServices |
| Management And General | 3430 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5028 | Total |
| Program Services | 339 | ProgramServices |
| Management And General | 4689 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169546 | Total |
| Program Services | 96074 | ProgramServices |
| Management And General | 73472 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31539 | Total |
| Program Services | 31008 | ProgramServices |
| Management And General | 531 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 660366 | 656566 | 3800 |
| BAD DEBT EXPENSE | 357160 | 357160 | |
| DUES & SUBSCRIPTIONS | 41894 | 9910 | 31984 |
| CAPITAL GRANT EXPENSE | 26912 | 19631 | 7281 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41334 | Total |
| Program Services | 25639 | ProgramServices |
| Management And General | 15695 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9139499 | Total |
| Program Services | 8238173 | ProgramServices |
| Management And General | 833267 | ManagementAndGeneral |
| Fundraising | 68059 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 813116 | BOY |
| EOY | 1112514 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 898588 | BOY |
| EOY | 1582443 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 327903 | BOY |
| EOY | 264399 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 154933 | BOY |
| EOY | 104245 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7456696 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1274154 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2368851 | BOY |
| EOY | 6182542 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4563391 | BOY |
| EOY | 9246143 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 821173 | BOY |
| EOY | 1298184 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 388328 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 821173 | BOY |
| EOY | 1686512 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3531869 | BOY |
| EOY | 7433266 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 190349 | BOY |
| EOY | 106365 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20000 | BOY |
| EOY | 20000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3742218 | BOY |
| EOY | 7559631 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4563391 | BOY |
| EOY | 9246143 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 3817413 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 0 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 0 | ReconcilationDonatedServices |
| Reconcilation Invest Expenses | 0 | ReconcilationInvestExpenses |
| Reconcilation Prior Adjustment | 0 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
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 | 5781560 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5340883 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5224844 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6737588 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9076484 | CurrentTaxYear |
| Total | 32161359 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5781560 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5340883 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5224844 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6737588 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9076484 | CurrentTaxYear |
| Total | 32161359 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 32161359 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19063 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4882 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1636 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3125 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5682 | CurrentTaxYear |
| Total | 34388 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 765 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1391 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1074 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5079 | CurrentTaxYear |
| Total | 8309 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 32204056 | TotalSupport |
| Gross Receipts From Admissions Etc | 14976837 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99860 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99760 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | OTHER INCOME, SCHEDULE A, PART II, LINE 10, DESCRIPTION - MISCELLANEOUS, COLUMN A - , COLUMN B - 765, COLUMN C - 1391, COLUMN D - 1074, COLUMN E - 5079, COLUMN F - 8309;, | GeneralExplanation |
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
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20010 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 42 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 42 | AdministrativeExpenses |
| End Of Year Balance | 20010 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20010 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 55 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 55 | AdministrativeExpenses |
| End Of Year Balance | 20010 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20010 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 59 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 59 | AdministrativeExpenses |
| End Of Year Balance | 20010 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20000 | BeginningOfYearBalance |
| Contributions | 10 | Contributions |
| Investment Earnings Or Losses | 286 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 286 | AdministrativeExpenses |
| End Of Year Balance | 20010 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20000 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 613 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 613 | AdministrativeExpenses |
| End Of Year Balance | 20000 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 133500 | OtherCostOrOtherBasis |
| Book Value | 133500 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1110219 | OtherCostOrOtherBasis |
| Depreciation | 25443 | Depreciation |
| Book Value | 1084776 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1022675 | OtherCostOrOtherBasis |
| Depreciation | 562919 | Depreciation |
| Book Value | 459756 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 936764 | OtherCostOrOtherBasis |
| Depreciation | 685792 | Depreciation |
| Book Value | 250972 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4253538 | OtherCostOrOtherBasis |
| Book Value | 4253538 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6182542 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Intended uses of endowment funds | Schedule D, Part V, Line 4 | ENDOWMENT EARNINGS ARE USED TO OFFSET THE FEES NOT COVERED BY SLIDING FEE PATIENTS. |
| FIN 48 (ASC 740) footnote | Schedule D, Part X, Line 2 | THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE ORGANIZATION IS NOT GENERALLY SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF INDIANA FOR THE LAST THREE YEARS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT DECEMBER 31, 2012 AND 2011. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CAROLYN YAP | ||||||||||||||
| PHYSICIAN | 164444 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7055 | 0 | 171499 | 0 | 0 | 0 |
| PIYUSH KUMAR | ||||||||||||||
| PHYSICIAN | 162555 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11932 | 0 | 174487 | 0 | 0 | 0 |
| TERRELL BOND | ||||||||||||||
| VP/CMO | 177031 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 19076 | 0 | 196107 | 0 | 0 | 0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 7560 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 308044 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | true | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Explanations of reporting method for number of contributions | Schedule M, Part I | DRUGS AND MEDICAL SUPPLIES: ESTIMATED NUMBER OF ITEMS RECEIVED. VACCINES FOR CHILDREN IS A STATE BASED PROGRAM THAT PROVIDES FREE VACCINES FOR KIDS. WE RECORD THE VALUE PER SHIPPING DOCUMENT WHEN THE SUPPLIES ARE RECIEVED FROM THE PROGRAM. |
| Number of contributions or items contributed. | Schedule M, part I, column (b), Line 20 | ESTIMATED NUMBER OF ITEMS RECEIVED. VACCINES FOR CHILDREN IS A STATE BASED PROGRAM THAT PROVIDES FREE VACCINES FOR KIDS. WE RECORD THE VALUE PER SHIPPING DOCUMENT WHEN THE SUPPLIES ARE RECIEVED FROM THE PROGRAM. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4A | (CONTINUED FROM PART III) NHCI'S MEDICAL SERVICES INCLUDE: - FAMILY MEDICINE - PREVENTATIVE MEDICINE AND SCREENING, ACUTE AND CHRONIC MANAGEMENT OF GENERAL DISEASE; - PEDIATRICS - WELL CHILD CARE; ACUTE AND CHRONIC CARE OF GENERAL PEDIATRIC DISEASE; - PRENATAL - FREE PREGNANCY TESTS; GENERAL PRENATAL CARE AND DELIVERY SERVICES; POST-PARTUM CARE; AND - WOMEN'S HEALTH - PREVENTATIVE AND WELL CARE, CONTRACEPTION, GYNECOLOGICAL SCREENING, ACUTE AND CHRONIC GYNECOLOGICAL CARE. NHCI'S DENTAL SERVICES INCLUDE: FULL FAMILY DENTAL CARE (PEDIATRIC DENTAL PATIENTS STARTING AT AGE 3); CAVITY PREVENTION; CAVITY TREATMENT; DENTAL X-RAYS; EXTRACTIONS; CROWNS; DENTURES; AND PROTECTIVE SEALANTS. NHCI ALSO PARTICIPATES IN THE WIC PROGRAM, A NUTRITION EDUCATION PROGRAM OFFERING HEALTHY FOODS AND OTHER SERVICES FREE OF CHARGE. THE WIC PROGRAM HELPS MANY FAMILIES (SINGLE PARENTS, MARRIED, WORKING, NOT WORKING, AND FOSTER PARENTS). EACH MONTH, APPROXIMATELY 12,500 CHILDREN AGES 0-5 RECEIVE NUTRITION COUNSELING AND VOUCHERS FOR NUTRITIOUS FOOD FROM NHCI'S WIC PROGRAM IN ALLEN, DEKALB, AND NOBLE COUNTIES. IN ADDITION, NHCI PARTICIPATES IN THE INDIANA STATE DEPARTMENT OF HEALTH PRENATAL SUBSTANCE USE PREVENTION PROGRAM (PSUPP), WHICH AIMS TO PREVENT NEGATIVE PREGNANCY OUTCOMES FROM MATERNAL DRUG USE IN PREGNANCY. THE PSUPP PROGRAM SEEKS TO EDUCATE CLINIC PATIENTS, THE GENERAL PUBLIC, AND MEDICAL AND SOCIAL SERVICE PROVIDERS ABOUT THE RISKS OF PREGNANCY COMPLICATIONS, SPONTANEOUS ABORTION, PRETERM BIRTH, LOW BIRTH WEIGHT AND FETAL NEUROLOGICAL AND ORGAN DAMAGE, WHICH CAN STEM FROM FETAL EXPOSURE TO EVERYTHING FROM NICOTINE AND ALCOHOL TO COCAINE AND OTHER DRUGS. |
| Delegate broad authority to a committee | Form 990, Part VI, Section A, Line 1a | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION. THE OFFICERS OF THE CORPORATION SHALL BE MEMBERS OF THE BOARD OF DIRECTORS AND CONSIST OF A CHAIR, VICE CHAIR, A SECOND VICE CHAIR, A SECRETARY, AND A TREASURER. ONLY THE OFFICES OF SECRETARY AND TREASURER MAY BE HELD BY THE SAME PERSON. THE BOARD OF DIRECTORS MAY, BY RESOLUTION OR RESOLUTIONS PASSED BY MAJORITY OF THE WHOLE BOARD, EMPOWER THE EXECUTIVE COMMITTEE TO ACT FOR AND ON BEHALF OF THE BOARD BETWEEN MEETINGS OF THE BOARD AND TO HAVE AND EXERCISE ALL OF THE POWER OF THE BOARD IN ACCORDANCE WITH THE GENERAL POLICY OF THE BOARD. WHEN ACTING FOR OR ON BEHALF OF THE BOARD OF DIRECTORS, THE EXECUTIVE COMMITTEE SHALL KEEP DUE RECORD OF ALL MEETINGS AND ACTIONS OF THE COMMITTEE AND SUCH RECORDS SHALL AT ALL TIMES BE OPEN TO THE INSPECTION OF ANY DIRECTOR AND FROM TIME TO TIME SHALL BE FILED WITH THE BOARD OF DIRECTORS AT THE MEETINGS THEREOF. SUCH RECORDS, AND ALL ACTIONS OF THE COMMITTEE RECORDED THEREIN, SHALL BE SUBJECT TO THE SUPERVISION AND RATIFICATION OF THE BOARD. NOTWITHSTANDING THE FOREGOING, THE DESIGNATION OF SUCH AN EXECUTIVE COMMITTEE AND THE DELEGATION THERETO OF AUTHORITY SHALL NOT OPERATE TO RELIEVE THE BOARD OF DIRECTORS OR ANY MEMBER THEREOF OF ANY RESPONSIBILITY IMPOSED ON IT OR ON ANY MEMBER BY LAW. THE FUNCTIONS OF THE EXECUTIVE COMMITTEE MAY BE PERFORMED BY MEETINGS OF THE COMMITTEE HELD IN THE REGULAR WAY OR BY A MAJORITY OF THE MEMBERS THEREOF, WHO BEING IN COMMUNICATION WITH EACH OTHER EITHER BY LETTER OR TELEPHONE, MAY DECIDE ANY MATTERS COMING WITHIN THE SCOPE OF THE COMMITTEE'S POWERS. A MAJORITY OF THE MEMBERS OF THE COMMITTEE SHALL CONSTITUTE A QUORUM AT SUCH MEETINGS FOR THE TRANSACTION OF BUSINESS. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | THE ORGANIZATION'S FINANCE COMMITTEE REVIEWS THE FULL FORM 990 IN DETAIL PRIOR TO IT BEING FINALIZED AND FILED. THEN EACH MEMBER OF THE FULL BOARD OF DIRECTORS ALSO RECEIVES A COPY OF THE FORM 990 PRIOR TO FILING. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | A POSSIBLE CONFLICT OF INTEREST EXISTS IF THE DIRECTOR, PRINCIPAL OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER HAS, EITHER DIRECTLY OR THROUGH FAMILY: (A) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH NHCI HAS A TRANSACTION OR ARRANGEMENT, (B) A COMPENSATION ARRANGEMENT WITH NHCI OR WITH ANY ENTITY OR INDIVIDUAL WITH WHOM NHCI HAS A TRANSACTION OR ARRANGEMENT, OR (C) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHOM NHCI IS NEGOTIATING A TRANSACTION ARRANGEMENT. COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION, AS WELL AS GIFTS OR FAVORS THAT ARE CONSIDERED SUBSTANTIAL. THE ORGANIZATION'S BOARD MEMBERS AND OFFICERS SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT AND COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. THE ORGANIZATION'S PRESIDENT/CEO AND BOARD CHAIR REVIEW THE RESPONSES TO DETERMINE IF ANY POTENTIAL CONFLICTS OF INTEREST EXIST. WHERE ANY OF THE ABOVE EXISTS FOR ANY POSSIBLE TRANSACTION, THE PERSON HAS A DUTY TO DISCLOSE THE EXISTENCE OF THE RELATIONSHIP AND ALL MATERIAL FACTS OF THE RELATIONSHIP TO THE BOARD OF DIRECTORS OR COMMITTEE. AFTER FULL DISCLOSURE, THE BOARD OR COMMITTEE WILL DETERMINE IF A CONFLICT ON INTEREST EXISTS. ANYONE WITH A CONFLICT OF INTEREST MUST EXCUSE HIMSELF OR HERSELF FROM THE DISCUSSION AND/OR VOTE FOR ANY CONFLICTING ISSUES. IN ADDITION, IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD OR COMMITTEE MAY: (A) DETERMINE IF NHCI CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT THAT DOES NOT RESULT IN A CONFLICT OF INTEREST, OR (B) DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN NHCI'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE AND ENTER INTO THE TRANSACTION OR ARRANGEMENT. |
| PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | FORM 990, PART VI, LINE 15A | AT LEAST EVERY THREE YEARS, HR PERFORMS A SALARY ANALYSIS WHICH COVERS ALL POSITIONS WITHIN THE ORGANIZATION; THE MOST RECENT SALARY ANALYSIS OCCURRED IN JANUARY 2010. THE SALARY ANALYSIS IS BASED ON SALARY SURVEYS INCLUDING LIKE ORGANIZATIONS AND THE LOCAL WAGES PAID IN THE FORT WAYNE AREA. THE DATA FROM THE SALARY SURVEY IS THEN USED BY THE BOARD OF DIRECTORS TO DETERMINE SALARY RANGES FOR ALL POSITIONS WITHIN THE ORGANIZATION UNTIL ANOTHER SALARY SURVEY IS COMPLETED, USUALLY WITHIN THREE YEARS. THE BOARD REVIEWS AND APPROVES THE SALARY RANGES FOR ALL POSITIONS, AND DOCUMENTS THEIR FINDINGS IN THE BOARD MEETING MINUTES. IN ADDITION, THE BOARD OF DIRECTORS REVIEWS AND APPROVES ANY RAISES FOR THE ORGANIZATION'S PRESIDENT/CEO AND OTHER OFFICERS ANNUALLY IN JANUARY WHEN THE ORGANIZATION'S BUDGET IS REVIEWED AND APPROVED. THE BOARD OF DIRECTORS ALSO COMPLETES THE PRESIDENT/CEO'S PERFORMANCE REVIEW; THE PRESIDENT/CEO COMPLETES THE PERFORMANCE REVIEWS FOR ALL OTHER OFFICERS. ANY RAISES APPROVED BY THE BOARD ARE SET AS A PERCENTAGE, WHICH IS BASED ON THE OUTCOME OF THE PERFORMANCE REVIEW. TOTAL COMPENSATION MUST STAY WITHIN THE COMPENSATION RANGE SET BY THE MOST RECENT HR SALARY ANALYSIS. THIS REVIEW PROCESS WAS LAST UNDERTAKEN IN JANUARY 2012. |
| PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES | FORM 990, PART VI, LINE 15B | SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
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