KISSITO HEALTHCARE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- KISSITO HEALTHCARE INC (EIN 36-3666533)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-10-09
- IRS object ID
- 201202839349300285
- Schema version
- 2011v1.2
- 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 | 2012-10-09T06:15:13-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | King Shores & Preston CPAs | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2707 Brambleton Ave SW | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24015 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363666533 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amity Fellowserve Inc | BusinessNameLine1 |
| Business Name Line2 | dba Kissito Healthcare | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | AMIT | NameControl |
| Phone | 5402650322 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5228 Valleypointe Parkway Bldg B | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24019 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Thomas M Clarke | Name |
| Title | President & CEO | Title |
| Date Signed | 2012-10-09 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CJ King | Name |
| Phone | 5407760771 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Thomas M Clarke | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5228 Valleypointe Parkway | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2985624 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.kissitopostacute.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1988 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | Kissito Healthcare and Kissito Healthcare International exist for the betterment and care of human life. The organization seeks to improve patient outcomes in our Domestic and Global services through a balanced engagement in academics, research and health care delivery.Kissito Healthcare International serves the world's most vulnerable people with low-cost, high impact healthcare solutions with a special focus on Maternal and Child Health. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 43 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 613 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2623713 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 2828151 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 112072 | InvestmentIncomePriorYear |
| Investment Income Current Year | 156860 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2735785 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2985624 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 71260 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 85055 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2899954 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2857714 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1372289 | OtherExpensePriorYear |
| Other Expenses Current Year | 2070490 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4343503 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5013259 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1607718 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2027635 | RevenuesLessExpensesCY |
| Total Assets BOY | 2692632 | TotalAssetsBOY |
| Total Assets EOY | 5866145 | TotalAssetsEOY |
| Total Liabilities BOY | 606874 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3406019 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2085758 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2460126 | NetAssetsOrFundBalancesEOY |
| Mission Description | Kissito Healthcare and Kissito Healthcare International exist for the betterment and care of human life. The organization seeks to improve patient outcomes in our Domestic and Global services through a balanced engagement in academics, research and health care delivery.Kissito Healthcare International serves the world's most vulnerable people with low-cost, high impact healthcare solutions with a special focus on Maternal and Child Health. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 4635458 | Expense |
| Revenue | 2828151 | Revenue |
| Description | Central management of related organizations providing long-term care for the elderly and handicapped in the form of housing and medical services. | Description |
| Total Program Service Expense | 4635458 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | 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 | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | true | 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 | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 32 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 43 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | 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 |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| 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 | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Lori Huffman | NamePerson |
| Telephone Number | 5402650322 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5228 Valleypointe Parkway Bldg B St | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24019 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Thomas Keefe | ||||||||
| Director | 5.00 | X | 0 | 0 | 0 | |||
| Lynn Hodge | ||||||||
| Chairman | 5.00 | X | 58249 | 0 | 0 | |||
| Wayne Fuquay | ||||||||
| Director | 5.00 | X | 0 | 0 | 11047 | |||
| Rev David Erickson | ||||||||
| Director | 5.00 | X | 9315 | 0 | 0 | |||
| Ana Clarke | ||||||||
| Director | 40.00 | X | 427476 | 0 | 3673 | |||
| Thomas M Clarke | ||||||||
| President & CEO | 40.00 | X | 488310 | 0 | 4569 | X | ||
| Salam Rasoul | ||||||||
| CFO | 40.00 | 179676 | 0 | 6963 | X | |||
| Sean Pressman | ||||||||
| COO | 40.00 | 109993 | 0 | 70 | X | |||
| Robert G Bell | ||||||||
| Secretary | 40.00 | 0 | 93639 | 0 | X | |||
| Connie Hawley | ||||||||
| Administrator | 40.00 | 0 | 153612 | 4013 | X | |||
| Robert McClintic | ||||||||
| Administrator | 40.00 | 0 | 183349 | 7822 | X | |||
| Angela Mattocks | ||||||||
| Chief Nursing Officer | 40.00 | 166688 | 0 | 8901 | X | |||
| Josh McGilliard | ||||||||
| VP of Marketing | 40.00 | 115203 | 0 | 7846 | X | |||
| Kathy Sanders | ||||||||
| Dir Compliance | 40.00 | 130206 | 0 | 4038 | X | |||
| Samuel Justus | ||||||||
| Administrator | 40.00 | 0 | 138358 | 4033 | X | |||
| Mabel Nkosi | ||||||||
| Administrator | 40.00 | 0 | 113580 | 4033 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1685116 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 682538 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 67008 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dr Steven R Hahn | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32 Bruce Street | AddressLine1 |
| City | Pleasantville | City |
| State | NY | State |
| ZIP Code | 10570 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Consulting | DescriptionOfServices |
| Compensation | 120000 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 613 | AllOtherContributions |
| Total Contributions | 613 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Management Fee Revenue | Description |
| Business Code | 551112 | BusinessCode |
| Total Revenue Column | 2828151 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2828151 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 2828151 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 156860 | TotalRevenueColumn |
| Exclusion | $156,860 | 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 |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2985624 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2828151 | RelatedOrExemptFunctionIncome |
| Exclusion | $156,860 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85055 | Total |
| Program Services | 85055 | ProgramServices |
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 | 1474930 | Total |
| Program Services | 1454568 | ProgramServices |
| Management And General | 20362 | ManagementAndGeneral |
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 | 1011505 | Total |
| Program Services | 1011505 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1381 | Total |
| Program Services | 1381 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207293 | Total |
| Program Services | 207293 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162605 | Total |
| Program Services | 162605 | ProgramServices |
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 | 107168 | Total |
| Management And General | 107168 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50900 | Total |
| Management And General | 50900 | 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 | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64767 | Total |
| Program Services | 64767 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 157686 | Total |
| Program Services | 157686 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50535 | Total |
| Program Services | 50535 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88702 | Total |
| Program Services | 88702 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148024 | Total |
| Program Services | 148024 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13470 | Total |
| Program Services | 13470 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168675 | Total |
| Management And General | 168675 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20155 | Total |
| Program Services | 20155 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16860 | Total |
| Program Services | 16860 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| Miscellaneous Expenses | 26835 | 26835 | |
| Equipment Rental | 47221 | 47221 | |
| Dues & Subscriptions | 62766 | 62766 | |
| Contract Services | 290766 | 290766 | |
| Bad Debt Expense (Recoveries) | 738843 | 738843 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17117 | Total |
| Program Services | 13256 | ProgramServices |
| Management And General | 3861 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5013259 | Total |
| Program Services | 4635458 | ProgramServices |
| Management And General | 377801 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7399 | BOY |
| EOY | 330584 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 475074 | BOY |
| EOY | 1608512 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15000 | BOY |
| EOY | 356664 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 697131 | BOY |
| EOY | 500082 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11963 | BOY |
| EOY | 6197 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 168444 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 89786 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40069 | BOY |
| EOY | 78658 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3100 | BOY |
| EOY | 3100 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1442896 | BOY |
| EOY | 2982348 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2692632 | BOY |
| EOY | 5866145 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 605154 | BOY |
| EOY | 990331 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2415688 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1720 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 606874 | BOY |
| EOY | 3406019 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2085758 | BOY |
| EOY | 2460126 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2085758 | BOY |
| EOY | 2460126 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2692632 | BOY |
| EOY | 5866145 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2027635 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2402003 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 613 | CurrentTaxYear |
| Total | 613 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2582587 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2695648 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2410945 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2623713 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2828151 | CurrentTaxYear |
| Total | 13141044 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2582587 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2695648 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2410945 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2623713 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2828764 | CurrentTaxYear |
| Total | 13141657 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 13141657 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1916 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 10970 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 70357 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 112072 | CurrentTaxYearMinus1Year |
| Current Tax Year | 156860 | CurrentTaxYear |
| Total | 352175 | Total |
Post1975 UBTI Post1975UBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1916 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 10970 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 70357 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 112072 | CurrentTaxYearMinus1Year |
| Current Tax Year | 156860 | CurrentTaxYear |
| Total | 352175 | Total |
Net Income From Other UBI NetIncomeFromOtherUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 300000 | CurrentTaxYearMinus3Years |
| Total | 300000 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2584503 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3006618 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2481302 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2735785 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2985624 | CurrentTaxYear |
| Total | 13793832 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.95270 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.96340 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.02550 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01440 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 67830 | OtherCostOrOtherBasis |
| Depreciation | 17453 | Depreciation |
| Book Value | 50377 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 100614 | OtherCostOrOtherBasis |
| Depreciation | 72333 | Depreciation |
| Book Value | 28281 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 78658 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Employee Advances | 16246 |
| Due from Affiliates | 2579802 |
| Deposits | 155681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2982348 | TotalBookValueOtherAssets |
| Total Revenue | 2985624 | TotalRevenue |
| Total Expenses | 5013259 | TotalExpenses |
| Excess Or Deficit For Year | -2027635 | ExcessOrDeficitForYear |
| Other | $2,402,003 | OtherAmount |
| Total Adjustments | 2402003 | TotalAdjustments |
| Excess Or Deficit Per FS | 374368 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 2985624 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 2985624 | RevenueSubtotal |
| Total Revenue Per Form990 | 2985624 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5013259 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 5013259 | ExpensesSubtotal |
| Total Expenses Per Form990 | 5013259 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part XI, Line 8 | Identifier |
| Return Reference | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | ReturnReference |
| Explanation | Capital Contribution from Affiliates $2402003 | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Purpose Of GrantPurposeOfGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| University of Texas | ||||||||||
| 7000 Fannin St 17th Floor | Houston | TX | 77030 | 741761309 | 501(c)(3) | 60000 | 0 | To Support Nursing PhD Program | ||
| Kissito Healthcare Intl Inc | ||||||||||
| 5228 Valleypointe Pkwy | Roanoke | VA | 24019 | 270900763 | 501(c)(3) | 0 | 20980 | Advance Healthcare in Africa | Cost | Ultrasound Equipment |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas M Clarke | |||||||||||
| 281785 | 203943 | 2582 | 55 | 4514 | 492879 | ||||||
| Salam Rasoul | |||||||||||
| 154868 | 10000 | 14808 | 120 | 6843 | 186639 | ||||||
| Robert McClintic | |||||||||||
| 133440 | 13719 | 36190 | 115 | 7707 | 191171 | ||||||
| Connie Hawley | |||||||||||
| 140658 | 4297 | 8657 | 95 | 3918 | 157625 | ||||||
| Angela Mattocks | |||||||||||
| 153227 | 13461 | 110 | 8791 | 175589 | |||||||
| Ana Clarke | |||||||||||
| 221586 | 204159 | 1731 | 55 | 3618 | 431149 | ||||||
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Thomas Clarke | NamePerson |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $656,215 | OriginalPrincipalAmount |
| Balance Due | 490082 | BalanceDue |
| Default | false | Default |
| Approved By Board | true | ApprovedByBoard |
| Written Agreement | true | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 490082 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Program Services Description: Research and Health Care Delivery/U.S. | Skilled Nursing and Rehabilitation Facilities: Kissito Healthcare (U.S.) operates nine exceptional skilled nursing and rehabilitation facilities throughout the U.S. states of Virginia, Arizona and Texas. These include Kissito Healthcare Bland in Bastian, VA; Kissito Healthcare Botetourt in Fincastle, VA; Kissito Healthcare Hot Springs in Hot Springs, VA; Kissito Healthcare Maple Grove in Lebanon, VA; Kissito Post Acute Alleghany in Low Moor, VA; Kissito Healthcare Hondo in Hondo, TX; Kissito Healthcare Midland in Midland, TX; Kissito Post Acute Cane Island in Katy, TX; and Kissito Healthcare Palm View in Yuma, AZ. We care for nearly 600 patients at any given time. Collaborative Patient Care Pathway (CP2) Model: Kissito researchers and physicians working with Dr. Steven Hahn have pioneered the Collaborative Patient Care Pathway (CP2) concept, which is now being piloted throughout our centers. Compared to standard care, the CP2 Model aims to address the organization's mission to deliver quality patient-centered care and demonstrate greater continuity of care, a shorter duration of stay and improved patient outcomes. Care is coordinated and integrated across all elements and in a culturally and linguistically appropriate manner. The intended outcomes of the CP2 Model include reduction in preventable rehospitalization, reduction in mortality and readmission rates, continuity of care across all post acute settings, and patient-driven shorter rehabilitation and recuperation periods as opposed to Payment Setting. The model is theory-based, collaborative and multidisciplinary, primarily focusing on patient-centered care. Phase 1 has been completed in 3 facilities, Kissito Palm View, Kissito Cane Island and Kissito Alleghany. Masonic Pathways in Alma, Michigan, a 200+ bed skilled nursing facility, has recently adopted the CP2 Model. With Masonic Pathways, Kissito is partnering to develop analysis tools to evaluate the CP2 Model's influence on patient care.Program of All-Inclusive Care for the Elderly (PACE): Kissito Healthcare (U.S.) was awarded designation as the sole provider of the Program of All-Inclusive Care for the Elderly (PACE) in the Roanoke Valley by the Department of Medical Assistance Services, Virginia on March 24, 2011. Under PACE, Kissito Healthcare will provide all-inclusive care to the nursing home-eligible population in the Roanoke Valley and surrounding areas in a Wellness-based model. This Model illustrates a meaningful care delivery reform for vulnerable and chronically ill populations and offers access to the full continuum of preventive, primary, acute, rehabilitative, and long-term care services for the frail and elderly while integrating all Medicare and Medicaid services into one seamless service package for beneficiaries. Improved outcomes include fewer hospitalizations, fewer nursing home admissions, higher contact with primary care providers, longer survival rates, better health, better quality of life, greater satisfaction with overall care arrangements, and better functional status. PACE has proven to be a highly successful model demonstrating significant health outcomes and at a much reduced cost. Kissito Healthcare intends to open its first PACE center in Roanoke in the first half of 2013. | |
| Program Services Description: Research and Health Care Delivery/Abroad | Kissito Healthcare International serves the world's most vulnerable people with low-cost, high-impact healthcare solutions with a special focus on improving Maternal and Child Health in the communities we serve. KHI works in East Africa specifically and currently has several active programs:Ethiopia: 1.Malaria Prevention: "Begara" for a Malaria-Free Society (joint program with CCRDA-Ethiopia and CORE Group-Ethiopia funded by The Global Fund)2.Morris Cerullo Kamashi Teaching Hospital: Construction, Operation and Health Delivery Integration Program 3.Operational, Public-Private Partnership with Kamashi Health Center, Kamashi Zone4.Ottoro Health Center5.Sipara Maternal and Child Health Hospital6.Southern, Nations, Nationalities, and People's Region (SNNPR) Emergency NutritionUganda:1.Emergency Obstetrical and Newborn Care Training Initiatives in Mbale and Manafwa Districts2.Operational, Public-Private Partnership with Bugobero Health Center IV, Manafwa District3.Training, Equipping Community Health Workers (CHW) Program in Manafwa District4.University Research Partnership: Pediatric Diarrhea in Uganda and Developing SocietiesSomalia:1.Health System Strengthening and Emergency NutritionSouth Sudan:1.Emergency Nutrition | |
| Initiative Descriptions/Uganda | Uganda: Emergency Obstetrical and Newborn Care Training Initiatives in Mbale and Manafwa DistrictsAddressing Uganda's unacceptably high maternal mortality rate and infant mortality ratio, Kissito is training local clinicians and lay people alike to identify high-risk mothers and help save lives through an intensive, multi-year training program involving more than 30 Ugandan physicians, nurses and midwives.Uganda: Operational, Public-Private Partnership with Bugobero Health Center IV, Manafwa DistrictKissito's Transformative Partnership Plan includes Kissito cost-sharing with the Manafwa District Government Administration to sponsor staff, medications, equipment, and ongoing training. Physical improvements include extensive renovations and upgrades to meet and exceed health codes put in place by the Ministry of Health. Uganda: Training, Equipping Community Health Workers (CHW) Program in Manafwa DistrictManafwa District has retained 183 CHWs but funding and staff constraints leave them undertrained and underutilized. Kissito will partner with the Administration of Manafwa and its Health Ministry to provide resources for ongoing training, equipping and deployment of these 183 individuals.Uganda: University Research Partnership: Pediatric Diarrhea in Uganda and Developing SocietiesThe major goal of Kissito/University of Texas School of Public Health's ambitious undertaking is to establish the etiology of diarrhea among children in the developing world, using populations in Ethiopia, Uganda and Mexico as points of entry into understanding this complex global issue. | |
| Initiative Descriptions/South Sudan | South Sudan: Emergency NutritionTogether with our partner Plan International, Kissito will assist with Emergency Nutrition efforts across South Sudan as the world's newest country gains stability. Working with the Nutrition Cluster, KHI hopes to assist with the large number of acutely malnourished cases of young children and women in need. | |
| Initiative Descriptions/Somalia | Somalia: Health System Strenghtening and Emergency NutritionWorking together with the World Health Organization (WHO) and the Ministry of Health, Kissito has committed to helping the state of Puntland with Health System Strengthening and Emergency Nutrition efforts over the coming years. Kissito will work first to strengthen the Regional Hospital in the Capital of Garowe, as well as assist with EN work at feeding centers. Kissito wants to work to support the Somali Health Sector Committee, and KHI is now part of the Health and Nutrition Clusters. | |
| Initiative Descriptions/Ethiopia | Ethiopia: Malaria Prevention: "Begara" for a Malaria-Free Society (joint program with CCRDA-Ethiopia and CORE Group-Ethiopia funded by The Global Fund)While Kissito's hospital is under construction in Kamashi, the organization is committed to fighting the root causes of malaria's deadly persistence. Together with CORE Group-Ethiopia and CCRDA, Kissito has joined forces with the government in its commitment to reduce malaria morbidity and mortality by 75% by 2013, compared to 2001-2005 levels. The program is a 3-year, multi-phase project combining various public relations/educational campaigns to improve treatment-seeking and preventative behaviors among Kamashi's people.Ethiopia: Morris Cerullo Kamashi Teaching Hospital: Construction, Operation and Health Delivery Integration Program The goal of The Morris Cerullo Kamashi Teaching Hospital Construction, Operation and Health Delivery Integration Program is to provide quality health services to communities in Kamashi Zone, with a special focus on maternal and child health. Program strategies include: Construction of a 60-bed acute care hospital of International Standards in the Kamashi Zone; operation of the hospital to International Standards; healthcare delivery system integration; health workers' training, placement and retention; health extension workers' training, placement and retention; improved medical equipment and supplies delivery through utilization of or strengthening of existing networks and partnerships and/or the development of new ones as appropriate.Ethiopia: Operational, Public-Private Partnership with Kamashi Health Center, Kamashi ZoneModeled on Kissito's success with the Bugobero Health Center in Uganda, Kissito is collaborating with the Ethiopian government in a cost-sharing, task-sharing model to address critical shortages in trained staff, supplies, equipment and essential drugs. In addition, Kissito's partnership with the government and the community it serves will address needed renovations and improvements to meet and exceed health codes set by the country's Ministry of Health. Ethiopia: Ottoro Health Center After acquiring the 90% constructed health facility in August 2011, Kissito works to complete renovations, meet equipment, supply and staffing needs and introduce the Ottoro Health Center as a safe, clean and fully functional Health Center IV serving the community. Similar to Kissito's Transformative Partnership Plan at the Bugobero Health Center in Uganda, Kissito plans to pursue a cost-sharing, responsibility-sharing model with the Hadiya Zone, SNNP Region where Ottoro is located. Ethiopia: Sipara Maternal and Child Health Hospital Kissito draws from a wealth of expertise in transforming challenged facilities to implement a revitalized Operational Plan for Sipara. Highlights include administrative reorganization, improvements to supply chain management, namely drugs and medical supplies, increased funding for departments in need, and provision of new and/or refurbished equipment. Ethiopia: SNNPR Emergency NutritionIn the Duna Wareda, with funding and collaboration coming from UNOCHA and Plan International, Kissito has been able to treat 4,184 Severely and Moderately Malnourished Children (SAM and MAM) and Pregnant and Lactating Women (PLW) using a Community-based Management of Acute Malnutrition (CMAM) approach. The failure of crops in 2010 and 2011 has led to a large need of humanitarian support. In the Halaba Special Wareda, Kissito will be helping 8,000+ more malnourished women and children in a new intervention. | |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The Organization's governing documents, conflict of interest policy and financial statements are made available to the public upon request. | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Compensation is determined by reference to comparability data and is subject to review and approval by top management of the company. | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Officers, directors and key employees are required to annually complete a written conflict of interest disclosure. | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | Form 990 will be reviewed by the Board of Directors before it is filed. | Form 990, Part VI, Line 11 |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Thomas M. Clarke, President/CEO and Director, is related by marriage to Ana Clarke, Director. | Form 990, Part VI, Line 2 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (17 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Kissito PACE of Roanoke Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 272972573 | Elder Home Care | VA | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Midland Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 272504940 | Nursing Care | TX | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Bugobelo Hospital and Medical University | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 263522690 | Provide Medical Services in Uganda | DE | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Kissito Healthcare International Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 270900763 | Promotion of International Healthcare and Education | DE | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Morris Cerullo Kamashi Teaching Hospital | ||||||||||
| 5228 Valeypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 383781006 | Provide Medical Services in Ethiopia | DE | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Amity Fellowserve of Hondo Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 311594605 | Nursing Care | MD | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Amity Fellowserve Realty of Hondo Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 830457457 | Leasing Real Estate to Nursing Facility | DE | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Amity Fellowserve of Cane Island Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 205234441 | General Partner of Entity Providing Nursing Care | DE | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS Realty of Yuma Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 204146559 | Leasing Real Estate to Nursing Facility | DE | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Lebanon Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 820556614 | Nursing Care | NV | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Bastian Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 202200573 | Nursing Care | VA | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Hot Springs Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 202200654 | Nursing Care | VA | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Low Moor Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 202200224 | Nursing Care | VA | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Fincastle Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 202200518 | Nursing Care | VA | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| AFS of Yuma Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 043541452 | Nursing Care | NV | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Amity Fellowserve of Katy Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 760561128 | Nursing Care | TX | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
| Amity Fellowserve of Minnesota Inc | ||||||||||
| 5228 Valleypointe Pkwy Bldg B Ste 1 | Roanoke | VA | 24019 | 043317081 | Administrative Support | MN | 501(c)(3) | 9 | Amity Fellowserve Inc | true |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cane Island Care Center LP | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5228 Valleypointe Pkwy Bldg B Ste 1 | AddressLine1 |
| City | Roanoke | City |
| State | VA | State |
| ZIP Code | 24019 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260496751 | EIN |
| Primary Activity | Nursing | PrimaryActivity |
| Legal Domicile State | TX | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amity Fellowserve | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Related | PredominantIncomeType |
| Share Of Total Income | -890529 | ShareOfTotalIncome |
| Share Of EOY Assets | 1678686 | ShareOfEOYAssets |
| Disproportionate Allocations | true | DisproportionateAllocations |
| General Or Managing Partner | true | GeneralOrManagingPartner |
| Percentage Ownership | 0.57000 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JMS BuildersDevelopers Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1481 Little Timber Ridge | AddressLine1 |
| City | Buchanan | City |
| State | VA | State |
| ZIP Code | 24066 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020548591 | EIN |
| Primary Activity | Construction | PrimaryActivity |
| Legal Domicile State | VA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amity Fellowserve | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | S Corp. | TypeOfEntity |
| Share Of Total Income | 235744 | ShareOfTotalIncome |
| Share Of EOY Assets | 238663 | ShareOfEOYAssets |
| Percentage Ownership | 0.50100 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (25 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| JMS BuildersDevelopers Inc | ||
| r | 112319 | FMV |
| JMS BuildersDevelopers Inc | ||
| b | 136175 | FMV |
| Cane Island Care Center LP | ||
| k | 440513 | Revenue % |
| Cane Island Care Center LP | ||
| d | 1952281 | FMV |
| Cane Island Care Center LP | ||
| a | 132241 | 5.25% Interest |
| AFS of Midland Inc | ||
| k | 271315 | Revenue % |
| AFS of Midland Inc | ||
| b | 637654 | FMV |
| Bugobelo Hospital and Medical University | ||
| b | 470931 | FMV |
| Kissito Healthcare International Inc | ||
| b | 456669 | FMV |
| Morris Cerullo Kamashi Teaching Hospital | ||
| b | 85740 | FMV |
| Amity Fellowserve of Hondo Inc | ||
| k | 142663 | Revenue % |
| Amity Fellowserve of Hondo Inc | ||
| b | 881513 | FMV |
| Amity Fellowserve Realty of Hondo Inc | ||
| c | 214427 | FMV |
| AFS of Lebanon Inc | ||
| k | 259654 | Revenue % |
| AFS of Lebanon Inc | ||
| c | 136934 | FMV |
| AFS of Bastian Inc | ||
| k | 203520 | Revenue % |
| AFS of Bastian Inc | ||
| b | 319491 | FMV |
| AFS of Hot Springs Inc | ||
| k | 187058 | Revenue % |
| AFS of Hot Springs Inc | ||
| b | 175295 | FMV |
| AFS of Low Moor Inc | ||
| k | 327443 | Revenue % |
| AFS of Low Moor Inc | ||
| c | 87232 | FMV |
| AFS of Fincastle Inc | ||
| k | 342757 | Revenue % |
| AFS of Yuma Inc | ||
| k | 463214 | Revenue % |
| AFS of Yuma Inc | ||
| c | 4680070 | FMV |
| Amity Fellowserve of Katy Inc | ||
| c | 271749 | FMV |
Comments