Bonita Community Health Center: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Bonita Community Health Center (EIN 59-3544102)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-10
IRS object ID
201212239349301116
Schema version
2010v3.4
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)
Timestamp2012-08-10T12:26:01-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14099 TAMIAMI TRAIL N STE 300AddressLine1
CityNAPLESCity
StateFLState
ZIP Code34103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN593544102EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BONITA COMMUNITY HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONINameControl
Phone2399491050Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13501 HEALTH CENTER BLVDAddressLine1
CityBONITA SPRINGSCity
StateFLState
ZIP Code34135ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSARA M MCCALLUMName
TitleCEOTitle
Phone2399491050Phone
Date Signed2012-08-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMELIA COOPER CPAName
Phone2392628686Phone
Date Prepared2012-08-10DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSARA MCCALLUMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13501 HEALTH CENTER BLVDAddressLine1
CityBONITA SPRINGSCity
StateFLState
ZIP Code34135ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9121725GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BONITAHEALTHCENTER.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE QUALITY AND COMPREHENSIVE HEALTHCARE IN A CARING ENVIRONMENT TO THE COMMUNITIES OF BONITA SPRINGS AND ESTERO.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees85TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2229473ContributionsGrantsPriorYear
Contributions Grants Current Year2480160ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4900896ProgramServiceRevenuePriorYear
Program Service Revenue CY5534268ProgramServiceRevenueCY
Investment Income Prior Year154InvestmentIncomePriorYear
Investment Income Current Year4868InvestmentIncomeCurrentYear
Other Revenue Prior Year-392965OtherRevenuePriorYear
Other Revenue Current Year-283090OtherRevenueCurrentYear
Total Revenue Prior Year6737558TotalRevenuePriorYear
Total Revenue Current Year7736206TotalRevenueCurrentYear
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 Year2901114SalariesEtcPriorYear
Salaries Etc Current Year3124974SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4345965OtherExpensePriorYear
Other Expenses Current Year4441202OtherExpensesCurrentYear
Total Expenses Prior Year7247079TotalExpensesPriorYear
Total Expenses Current Year7566176TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-509521RevenuesLessExpensesPriorYear
Revenues Less Expenses CY170030RevenuesLessExpensesCY
Total Assets BOY18504478TotalAssetsBOY
Total Assets EOY18098962TotalAssetsEOY
Total Liabilities BOY28154052TotalLiabilitiesBOY
Total Liabilities EOY26687166TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-9649574NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8588204NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionOUR MISSION IS TO PROVIDE QUALITY AND COMPREHENSIVE HEALTHCARE IN A CARING ENVIRONMENT TO THE COMMUNITIES OF SOUTHWEST FLORIDA THROUGH THE COLLECTIVE EFFORTS OF LEE MEMORIAL HEALTHCARE SYSTEM AND THE NCH HEALTHCARE SYSTEM.THE BONITA COMMUNITY HEALTH CENTER WAS ESTABLISHED AS A PARTNERSHIP BETWEEN TWO OF THE MOST EXPERIENCED AND RESPECTED NAMES IN SOUTHWEST FLORIDA HEALTHCARE: LEE MEMORIAL HEALTH SYSTEM AND NCH HEALTHCARE SYSTEM. AS A RESULT, THE FACILITY IS A COMPREHENSIVE DIAGNOSTIC, TREATMENT, REHABILITATION AND SURGICAL CENTER SPECIFICALLY DESIGNED WITH OUR PATIENTS' CARE AND COMFORT IN MINDEQUIPPED WITH THE LATEST TECHNOLOGY, OUR STATE-OF-THE-ART CENTER PROVIDES A WIDE SPECTRUM OF HEALTH SERVICES AND PROGRAMS. IN ADDITION TO A WALK-IN CLINIC, PHYSICIAN REFERRAL AND PATIENT EDUCATION AREAS, THE BONITA COMMUNITY HEALTH CENTER OFFERS A ONE-STOP CENTER THAT CATERS TO ALL FACETS OF HEALTHCARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6124856Expense
Revenue5251178Revenue
DescriptionBONITA COMMUNITY HEALTH CENTER, INC. ("BCHC") IS A NONPROFIT ORGANIZATION WHICH MEANS REVENUE GENERATED GETS REINVESTED BACK INTO THE COMMUNITY IN TERMS OF IMPROVED EQUIPMENT, SERVICES, AND FACILITIES. BCHC DEVELOPS AND PROVIDES AN OPERATION OF COMPREHENSIVE DIAGNOSTIC TREATMENT AND SURGICAL HEALTHCARE FACILITY SERVING THE BONITA SPRINGS AND ESTERO COMMUNITIES. EXAMPLES INCLUDE URGENT CARE CLINIC, RADIOLOGY SERVICES, AND A REHABILITATION CENTER. EQUIPPED WITH THE LATEST TECHNOLOGY, OUR STATE-OF-THE-ART CENTER PROVIDES A WIDE SPECTRUM OF HEALTH SERVICES AND PROGRAMS. IN ADDITION TO A WALK-IN CLINIC, PHYSICIAN REFERRAL AND PATIENT EDUCATION AREAS, THE BONITA COMMUNITY HEALTH CENTER OFFERS A ONE-STOP CENTER THAT CATERS TO ALL FACETS OF HEALTHCARE. THERE ARE OVER 50 PRIMARY AND SPECIALTY CARE PHYSICIANS UNDER ONE ROOF SERVING APPROXIMATELY 30,000 PATIENTS THROUGHOUT THE COMMUNITY.Description
Total Program Service Expense6124856TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
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 Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees85NumberOfEmployees
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 Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGENE HIGGINS CFONamePerson
Telephone Number2399491050TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13501 HEALTH CENTER BLVDAddressLine1
CityBONITA SPRINGSCity
StateFLState
ZIP Code34135ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
DAVID CATO
CO CHAIRMAN2.00X017236424670
VICKI D ORR
CO CHAIRMAN2.00X036949431028
NOBLE ARRINGTON
TREASURER2.00X015448726474
KEVIN NEWINGHAM
SECRETARY2.00X020792823618
KEVIN D COOPER
DIRECTOR2.00X037479918113
MIKE GERMAN
DIRECTOR2.00X026619125590
MICHAEL RILEY
DIRECTOR2.00X018996129055
SUZANNE BRADACH
DIRECTOR & CEO40.00X017844024555X
BERTRAND GENE HIGGINS
CFO40.0011013309543X
FieldValueIRS element (for citing)
Total Reportable Comp From Org110133TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1913664TotalReportableCompFrmRltdOrgs
Total Other Compensation212646TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
NAPLES RADIOLOGY
PO BOX 8089NAPLESFL341018089RADIOLOGY SERVICES377030
LEE MEMORIAL HEALTH SYSTEMS
636 DEL PRADO BLVDCAPE CORALFL33990PHYSICIAN SERVICES243449
NAPLES COMMUNITY HOSPITAL
PO BOX 413001NAPLESFL34101PHYSICIAN SERVICES168020
CORONET CLEARING SERVICES LTD
1876 SW 11TH TERRACE 204MIAMIFL33135JANITORIAL SERVICES104196
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Related Organizations2480160RelatedOrganizations
Total Contributions2480160TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICESDescription
Business Code990999BusinessCode
Total Revenue Column5534268TotalRevenueColumn
Related Or Exempt Function Income5534268RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue5534268TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column118TotalRevenueColumn
Exclusion$118ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1102429Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1385519Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-283090Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-283090TotalRevenueColumn
Related Or Exempt Function Income-283090RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other4750Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other4750Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4750TotalRevenueColumn
Exclusion$4,750ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7736206TotalRevenueColumn
Related Or Exempt Function Income5251178RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,868ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total108826Total
Management And General108826ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2504520Total
Program Services1978713ProgramServices
Management And General525807ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total20766Total
Program Services14439ProgramServices
Management And General6327ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total275976Total
Program Services208632ProgramServices
Management And General67344ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total214886Total
Program Services163788ProgramServices
Management And General51098ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2492Total
Program Services465ProgramServices
Management And General2027ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total21434Total
Program Services14232ProgramServices
Management And General7202ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total561378Total
Program Services498072ProgramServices
Management And General63306ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total142592Total
Program Services98122ProgramServices
Management And General44470ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total722381Total
Program Services658365ProgramServices
Management And General64016ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total82566Total
Program Services55319ProgramServices
Management And General27247ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total283809Total
Program Services280157ProgramServices
Management And General3652ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total2568Total
Program Services1114ProgramServices
Management And General1454ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total961383Total
Program Services746703ProgramServices
Management And General214680ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total554685Total
Program Services368247ProgramServices
Management And General186438ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total77912Total
Program Services52200ProgramServices
Management And General25712ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
LEASE ON EQUIPMENT3793703721147256
EQUIPMENT SERVICE CONTR32393931302810911
BAD DEBT ALLOWANCE153948153948

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total170745Total
Program Services147198ProgramServices
Management And General23547ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7566176Total
Program Services6124856ProgramServices
Management And General1441320ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY250BOY
EOY3449EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY167139EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY415342BOY
EOY417255EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY128819BOY
EOY110982EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY110577BOY
EOY83805EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis26682207LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9782137LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY17209637BOY
EOY16900070EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY372502EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY639853BOY
EOY43760EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY18504478BOY
EOY18098962EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY720285BOY
EOY543497EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6110000BOY
EOY5900000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY19278093BOY
EOY19082205EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2045674BOY
EOY1161464EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY28154052BOY
EOY26687166EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-9649574BOY
EOY-8588204EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-9649574BOY
EOY-8588204EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18504478BOY
EOY18098962EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses170030ReconcilationRevenueExpenses
Reconcilation Other Changes891340ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2520020OtherCostOrOtherBasis
Book Value2520020BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13277676OtherCostOrOtherBasis
Depreciation3452150Depreciation
Book Value9825526BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5673854OtherCostOrOtherBasis
Depreciation1541054Depreciation
Book Value4132800BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4737173OtherCostOrOtherBasis
Depreciation4448358Depreciation
Book Value288815BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis473484OtherCostOrOtherBasis
Depreciation340575Depreciation
Book Value132909BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings16900070TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
INTEREST RATE SWAP OBLIGATION$1,008,212
INTEREST PAYABLE$94,175
TENANT DEPOSITS$10,560
DUE TO NAPLES RADIOLOGY$35,036
OTHER DEPOSITS$13,481
FieldValueIRS element (for citing)
Total Of Amounts1161464TotalOfAmounts
Total Revenue7736206TotalRevenue
Total Expenses7566176TotalExpenses
Excess Or Deficit For Year170030ExcessOrDeficitForYear
Other$891,340OtherAmount
Total Adjustments891340TotalAdjustments
Excess Or Deficit Per FS1061370ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt10013065TotRevenueEtcAuditedFinclStmt
Other Revenues2276859OtherRevenues
Revenue Not Rptd F9902276859RevenueNotRptdF990
Revenue Subtotal7736206RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9907736206TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt8951695TotExpensesEtcAuditedFinclStmt
Other Expenses Included1385519OtherExpensesIncluded
Expenses Not Rptd F9901385519ExpensesNotRptdF990
Expenses Subtotal7566176ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9907566176TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE ORGANIZATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, THE ORGANIZATION'S 2007 TO 2009 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 891,340.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 891,340. RENTAL EXPENSES REPORTED ON PART VIII LINE 6(B) 1,385,519.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES REPORTED ON PART VIII LINE 6(B) 1,385,519.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
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 (8 entries)

Base 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
DAVID CATO
0172364000008618016052019703400
VICKI D ORR
033785401514001650009800021228040052200
NOBLE ARRINGTON
0139726058890887206144020330018096100
KEVIN NEWINGHAM
02079280000010391013227023154600
KEVIN D COOPER
03431590151400165000980008313039291200
MIKE GERMAN
02661910000012250013340029178100
MICHAEL RILEY
01898930680007753021302021901600
SUZANNE BRADACH
0178440000008922015633020299500

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2DAVID CATO, KEVIN NEWINGTON, MIKE GERMAN, AND SUZANNE BRADACH HAVE A BUSINESS RELATIONSHIP. VICKI HALE, NOBLE ARRINGTON, MICHAEL RILEY, AND KEVIN COOPER HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION SENDS A PDF COPY OF THE ENTIRE FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW. ANY FEEDBACK IS SENT TO THE CFO FOR DISCUSSION PRIOR TO FILING WITH THE IRS.
THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD EVERY YEAR AND SIGNED BY THE CHAIRPERSON. IT STATES A FULL DISCLOSURE OF ALL FACTS PERTAINING TO ANY TRANSACTION THAT IS SUBJECT TO A CONFLICT OF INTEREST SHALL BE MADE.FORM 990, PART VI, SECTION B, LINE 12C
THE CEO IS A LOANED EXECUTIVE FROM THE LEE MEMORIAL HEALTH SYSTEM. THE CEO PAY IS DETERMINED BASED ON MARKET SURVEYS AND IS APPROVED BY THE LMHS BOARD OF DIRECTORS. COMPENSATION PROCESS FOR OFFICERS PAY IS DETERMINED BASED ON MARKET SURVEYS AND APPROVAL BY THE CEO.FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 891,340. TOTAL TO FORM 990, PART XI, LINE 5: 891,340.FORM 990, PART XI, LINE 5:
THE PROCESS OF ASSUMING RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
NCH HEALTHCARE SYSTEM INC
PO BOX 413029NAPLESFL341013029592314655HOLDING COMPANYFL501(C)(3)8,11N/A0
LEE MEMORIAL HEALTH SYSTEM
2776 CLEVELAND AVENUEFORT MYERSFL33901590714812ACUTE CARE HOSPITALFLSTATE GOVERNMENTAL E6N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
NCH HEALTHCARE SYSTEM
C1240080
LEE MEMORIAL HEALTH SYSTEM
C1240080
NCH HEALTHCARE SYSTEM
L180273
LEE MEMORIAL HEALTH SYSTEM
L249219
NCH HEALTHCARE SYSTEM
I77367
LEE MEMORIAL HEALTH SYSTEM
I325454
LEE MEMORIAL HEALTH SYSTEM
O44644
NCH HEALTHCARE SYSTEM
E656412
LEE MEMORIAL HEALTH SYSTEM
E656412

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