FURP.ORG / PUBLIC DATA EXPLORER

SHERRILL HOUSE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SHERRILL HOUSE INC (EIN 04-2104321)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201323199349303102
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

FieldValueIRS element (for citing)
Timestamp2013-11-15T09:49:30-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1
CityQUINCYCity
StateMAState
ZIP Code02169ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042104321EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SHERRILL HOUSE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSHERNameControl
Phone6177312400Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH HUNTINGTON AVENUEAddressLine1
CityBOSTONCity
StateMAState
ZIP Code02130ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARC SCHULTZName
TitleCHIEF FINANCIAL OFFICERTitle
Phone6177312400Phone
Date Signed2013-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameROBERT DILLANName
PTINP01688008PTIN
Phone6179848100Phone
Date Prepared2013-11-11DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARC SCHULTZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1135 SOUTH HUNTINGTON AVENUEAddressLine1
CityBOSTONCity
StateMAState
ZIP Code02130ZIPCode
FieldValueIRS element (for citing)
Gross Receipts23372395GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1907YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionSHERRILL HOUSE PROVIDES HIGH QUALITY MEDICAL, NURSING, AND REHABILITATION SERVICES ON AN IN-PATIENT BASIS TO MEN AND WOMEN WITHOUT DISTINCTION TO RACE, COLOR, OR NATIONAL ORIGIN.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees381TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year246576ContributionsGrantsPriorYear
Contributions Grants Current Year864473ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19976532ProgramServiceRevenuePriorYear
Program Service Revenue CY20079742ProgramServiceRevenueCY
Investment Income Prior Year2220529InvestmentIncomePriorYear
Investment Income Current Year203506InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year22443637TotalRevenuePriorYear
Total Revenue Current Year21147721TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year15361570SalariesEtcPriorYear
Salaries Etc Current Year15454985SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year138560TotalFundrsngExpCurrentYear
Other Expense Prior Year7292110OtherExpensePriorYear
Other Expenses Current Year7364776OtherExpensesCurrentYear
Total Expenses Prior Year22653680TotalExpensesPriorYear
Total Expenses Current Year22819761TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-210043RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1672040RevenuesLessExpensesCY
Total Assets BOY41657238TotalAssetsBOY
Total Assets EOY41759151TotalAssetsEOY
Total Liabilities BOY15272100TotalLiabilitiesBOY
Total Liabilities EOY16219985TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY26385138NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY25539166NetAssetsOrFundBalancesEOY
Mission DescriptionSHERRILL HOUSE PROVIDES HIGH QUALITY MEDICAL, NURSING, AND REHABILITATION SERVICES ON AN IN-PATIENT BASIS TO MEN AND WOMEN WITHOUT DISTINCTION TO RACE, COLOR, OR NATIONAL ORIGIN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense20909025Expense
Revenue19617430Revenue
DescriptionPROVIDE SKILLED NURSING HOME CARE TO THE ELDERLY AND DISABLED.Description
Total Program Service Expense20909025TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109633NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees381NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARC SCHULTZ CFONamePerson
Telephone Number6177312400TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1135 SOUTH HUNTINGTON AVEAddressLine1
CityBOSTONCity
StateMAState
ZIP Code02130ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
RICHARD W BENKA ESQ
PRESIDENT/ TRUSTEE2.00XX000
REV THOMAS B KENNEDY
CHAIRMAN/ TRUSTEE2.00XX000
FREDERICA SEE
TREASURER/ TRUSTEE2.00XX000
HELEN H GATES
ASST CLERK/ TRUSTEE2.00XX000
BAYARD HENRY
TRUSTEE1.00X000
DAVID A KIRCHNER
CO-VICE PRESIDENT/ TRUSTEE2.00XX000
SUSAN W ADAM
CO-VICE PRESIDENT/ TRUSTEE2.00XX000
ROBERT S HURLBURT JR
TRUSTEE1.00X000
ALEXANDER T BOK
TRUSTEE1.00X000
WILLIAM STEUL
TRUSTEE1.00X000
DAVID LAFFEY
TRUSTEE1.00X000
BARBARA BAUMAN
TRUSTEE2.00X000
EDWARD BALDINI
TRUSTEE1.00X000
MARGUERITE LLOYD
TRUSTEE1.00X000
WALTER S BURRAGE JR
TRUSTEE1.00X000
PATRICK STAPLETON
CEO40.00X234670019716
MARC SCHULTZ
CFO40.00X143900019469
JAMES DAME
DIRECTOR OF THERAPY40.00109621021176X
DEIDRE O'SULLIVAN
DON40.00140365012991X
KAHATCHIK OHANNESSIAN
PHYSICAL THERAPIST40.00113701015650X
DONALD GREGORY
DIRECTOR OF HUMAN RESOURCES40.0011656706916X
ROBIN ERCHA
ASSISTANT DON40.00109953021201X
FieldValueIRS element (for citing)
Total Reportable Comp From Org968777TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation117119TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLENBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1300 CROWN COLONY DRIVE SUITE 310AddressLine1
CityQUINCYCity
StateMAState
ZIP Code02169ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesAUDITING & CONSULTINGDescriptionOfServices
Compensation104000Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions864473AllOtherContributions
Total Contributions864473TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column20079742TotalRevenueColumn
Related Or Exempt Function Income20079742RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue20079742TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column665818TotalRevenueColumn
Exclusion$665,818ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1762362Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2224674Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-462312Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-462312TotalRevenueColumn
Related Or Exempt Function Income-462312RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column21147721TotalRevenueColumn
Related Or Exempt Function Income19617430RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$665,818ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total405791Total
Management And General405791ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total12848780Total
Program Services12175017ProgramServices
Management And General673763ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1159016Total
Program Services1091863ProgramServices
Management And General67153ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1041398Total
Program Services958547ProgramServices
Management And General82851ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total53472Total
Management And General53472ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total74000Total
Management And General74000ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total65754Total
Management And General65754ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total350023Total
Program Services325358ProgramServices
Management And General24665ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total26417Total
Program Services26417ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total298509Total
Management And General298509ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total548052Total
Program Services548052ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total36481Total
Program Services36481ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total171781Total
Program Services171781ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1901413Total
Program Services1901413ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total216002Total
Program Services216002ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
USER FEE10077451007745
FOOD701092701092
PHARMACY579375579375
THERAPY SUPPLIES289192289192

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1045468Total
Program Services880690ProgramServices
Management And General26218ManagementAndGeneral
Fundraising138560Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total22819761Total
Program Services20909025ProgramServices
Management And General1772176ManagementAndGeneral
Fundraising138560Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY764122BOY
EOY424777EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1600BOY
EOY1600EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3131062BOY
EOY3262532EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY23083BOY
EOY23083EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY231438BOY
EOY211018EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis47884266LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21395567LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY27904755BOY
EOY26488699EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9078550BOY
EOY10089892EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY578386EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY522628BOY
EOY679164EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY41657238BOY
EOY41759151EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2847423BOY
EOY3716712EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY12424677BOY
EOY12425000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY78273EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY15272100BOY
EOY16219985EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY25240517BOY
EOY23855510EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY62045BOY
EOY19519EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1082576BOY
EOY1664137EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26385138BOY
EOY25539166EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41657238BOY
EOY41759151EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1672040ReconcilationRevenueExpenses
Reconciliation Unrealized Invest839361ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment-13296ReconcilationPriorAdjustment
Reconcilation Other Changes3ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years204103CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years167296CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years133834CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year246576CurrentTaxYearMinus1Year
Current Tax Year864473CurrentTaxYear
Total1616282Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19333074CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years19678841CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19789749CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19976532CurrentTaxYearMinus1Year
Current Tax Year20079743CurrentTaxYear
Total98857939Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19537177CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years19846137CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19923583CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20223108CurrentTaxYearMinus1Year
Current Tax Year20944216CurrentTaxYear
Total100474221Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years56000CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years66354CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year135000CurrentTaxYearMinus1Year
Current Tax Year25000CurrentTaxYear
Total282354Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years56000CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years66354CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year135000CurrentTaxYearMinus1Year
Current Tax Year25000CurrentTaxYear
Total282354Total
FieldValueIRS element (for citing)
Public Support Total509100191867PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years708894CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years898895CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years827066CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year594033CurrentTaxYearMinus1Year
Current Tax Year665818CurrentTaxYear
Total3694706Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years708894CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years898895CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years827066CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year594033CurrentTaxYearMinus1Year
Current Tax Year665818CurrentTaxYear
Total3694706Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1500CurrentTaxYearMinus4Years
Total1500Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years20247571CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20745032CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20750649CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20817141CurrentTaxYearMinus1Year
Current Tax Year21610034CurrentTaxYear
Total104170427Total
FieldValueIRS element (for citing)
Public Support Percentage5090.96180PublicSupportPercentage509
Prior Year Support Percentage0.94630PriorYearSupportPercentage
Investment Income Percentage0.03550InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.03610PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$2,324OtherActivitiesAmount
Total Lobbying Expenditures IIB2324TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPAID MEMBERSHIP DUES TO STATE HEALTHCARE ORGANIZATION.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1144621BeginningOfYearBalance
Contributions615033Contributions
Investment Earnings Or Losses129605InvestmentEarningsOrLosses
Other Expenditures205603OtherExpenditures
End Of Year Balance1683656EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1438180BeginningOfYearBalance
Contributions68440Contributions
Investment Earnings Or Losses-9842InvestmentEarningsOrLosses
Other Expenditures352157OtherExpenditures
End Of Year Balance1144621EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3058467BeginningOfYearBalance
Contributions89728Contributions
Investment Earnings Or Losses81335InvestmentEarningsOrLosses
Other Expenditures1791350OtherExpenditures
End Of Year Balance1438180EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.99000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis860636OtherCostOrOtherBasis
Book Value860636BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16048704OtherCostOrOtherBasis
Depreciation5323849Depreciation
Book Value10724855BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis24746784OtherCostOrOtherBasis
Depreciation11114071Depreciation
Book Value13632713BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5999980OtherCostOrOtherBasis
Depreciation4736328Depreciation
Book Value1263652BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis228162OtherCostOrOtherBasis
Depreciation221319Depreciation
Book Value6843BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings26488699TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO MEDICAIDDescription
Amount$78,273Amount
FieldValueIRS element (for citing)
Total Of Amounts78273TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt21921330TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments839361NetUnrealizedGainsInvestments
Other Revenues2OtherRevenues
Revenue Not Rptd F990839363RevenueNotRptdF990
Revenue Subtotal21081967RevenueSubtotal
Investment Expenses Not Included65754InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt65754RevenueNotRptdOnFinStmt
Total Revenue Per Form99021147721TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt22754006TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal22754006ExpensesSubtotal
Investment Expenses Not Included265754InvestmentExpensesNotIncluded2
Other Expenses Not Included1OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt65755ExpensesNotRptdOnFinStmt
Total Expenses Per Form99022819761TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR CHAPLAINCY, VOLUNTEER, FUND FACILITY AND VARIOUS OTHER PROGRAMS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S TAX RETURNS FROM 2008 THROUGH 2011 ARE OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:ROUNDING 2.
PART XII, LINE 4B - OTHER ADJUSTMENTS:ROUNDING 1.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PATRICK STAPLETON
CEO2346700000000197160254386000
MARC SCHULTZ
CFO1439000000000194690163369000
DEIDRE O'SULLIVAN
DON1403650000000129910153356000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE CLASS OF MEMBERS ARE THE TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7ATHE TRUSTEES ELECT MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7BTHE TRUSTEES APPROVE DECISIONS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11CEO WILL EMAIL ALL TRUSTEES A COPY OF THE 990 TO REVIEW PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 15AA STUDY IS CONDUCTED BY AN OUTSIDE CONSULTING COMPANY, WHICH USES COMPARABILITY DATA ON SALARIES WITHIN THE INDUSTRY. USING THESE REPORTS, AS WELL AS OTHER FACTORS, THE APPROVAL OF COMPENSATION IS DISCUSSED AND VOTED ON BY THE BOARD, AND DOCUMENTED WITHIN THE BOARD MEETING MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:ROUNDING 3.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT