ILIULIUK FAMILY AND HEALTH SERVICES INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ILIULIUK FAMILY AND HEALTH SERVICES INC (EIN 92-0041961)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-12
IRS object ID
201141329349301849
Schema version
2009v1.7
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)
Timestamp2011-05-12T16:32:24-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LarsonAllen LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18131 W Grandridge BlvdAddressLine1
CityKennewickCity
StateWAState
ZIP Code99336ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN920041961EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Iliuliuk Family & Health ServicesBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlILIUNameControl
Phone9075811202Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 144AddressLine1
CityUnalaskaCity
StateAKState
ZIP Code99685ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSonia Handforth-KomeName
TitleExecutive DirecTitle
Date Signed2011-05-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSharon R HunterName
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSonia Handforth-KomeNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 144AddressLine1
CityUnalaskaCity
StateAKState
ZIP Code996850144ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5034585GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web Sitewww.ifhs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileAKStateLegalDomicile
Activity Or Mission DescriptionTo provide primary health care and emergency medical services to permanent and temporary residents of Unalaska, the fishing fleet of the Bering sea, and the outlying islands of Atka, Akutan, and Nikolski.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees61TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1521801ContributionsGrantsPriorYear
Contributions Grants Current Year1843360ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4128288ProgramServiceRevenuePriorYear
Program Service Revenue CY3095533ProgramServiceRevenueCY
Investment Income Prior Year54127InvestmentIncomePriorYear
Investment Income Current Year24779InvestmentIncomeCurrentYear
Other Revenue Prior Year80418OtherRevenuePriorYear
Other Revenue Current Year70913OtherRevenueCurrentYear
Total Revenue Prior Year5784634TotalRevenuePriorYear
Total Revenue Current Year5034585TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3080373SalariesEtcPriorYear
Salaries Etc Current Year3272655SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2431476OtherExpensePriorYear
Other Expenses Current Year2368936OtherExpensesCurrentYear
Total Expenses Prior Year5511849TotalExpensesPriorYear
Total Expenses Current Year5641591TotalExpensesCurrentYear
Revenues Less Expenses Prior Year272785RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-607006RevenuesLessExpensesCY
Total Assets BOY7609068TotalAssetsBOY
Total Assets EOY7075098TotalAssetsEOY
Total Liabilities BOY559608TotalLiabilitiesBOY
Total Liabilities EOY632644TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7049460NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6442454NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide primary health care and emergency medical services to permanent and temporary residents of Unalaska, the fishing fleet of the Bering sea, and the outlying islands of Atka, Akutan, and Nikolski.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4692981Expense
Revenue3093690Revenue
DescriptionProvided primary health care and emergency medical services to permanent and temporary residents of Unalaska, the fishing fleet of the Bering sea, and the outlying islands of Atka, Akutan, and Nikolski.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense289027Expense
DescriptionProvided counseling to permanent and temporary residents of Unalaska, the fishing fleet of the Bering sea, and the outlying islands of Atka, Akutan and Nikolski.Description
FieldValueIRS element (for citing)
Total Program Service Expense4982008TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109650NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees61NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledAKStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTom B Smoll JDNamePerson
Telephone Number9075811202TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 144AddressLine1
CityUnalaskaCity
StateAKState
ZIP Code99685ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Thomas Enlow
Board Member1.00X000
Sonia Handforth-Kome
Executive Direc55.0014591900XX
Sinclar Wilt
Officer1.50X000X
Sharon Svarny-Livingston
Board Member1.00X000X
Richard Peck
Officer2.50X000X
Michael Sheffield
Board Member1.00X000
Heidi Baines
Doctor30.0015034800X
D Tyrell McGirt
Board Member1.00X000
Craig Booth
Doctor0.15000000X
Char Grisvold
98685-01441.00X000
Ann Nora Ehret
Doctor30.0010250000X
Alena Syverson
Board Member1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org548767TotalReportableCompFromOrg
Number Individuals GT100 K4NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions1843360AllOtherContributions
Total Contributions1843360TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service RevenueDescription
Total Revenue Column3095533TotalRevenueColumn
Related Or Exempt Function Income3095533RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3095533TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column24779TotalRevenueColumn
Exclusion$24,779ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real70913Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real70913Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column70913TotalRevenueColumn
Exclusion$70,913ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5034585TotalRevenueColumn
Related Or Exempt Function Income3095533RelatedOrExemptFunctionIncome
Exclusion$95,692ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total139450Total
Program Services117425ProgramServices
Management And General22025ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2211296Total
Program Services1862039ProgramServices
Management And General349257ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total742034Total
Program Services718581ProgramServices
Management And General23453ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total179875Total
Program Services174190ProgramServices
Management And General5685ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total295571Total
Program Services268282ProgramServices
Management And General27289ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total679073Total
Program Services627226ProgramServices
Management And General51847ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total26555Total
Program Services23236ProgramServices
Management And General3319ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total20027Total
Program Services17464ProgramServices
Management And General2563ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total368694Total
Program Services322761ProgramServices
Management And General45933ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total123088Total
Program Services108318ProgramServices
Management And General14770ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Technical assistance consultat58778514317347
Supplies46691740062566292
Printing and advertising1088395191364
Bank charges/fees12934113171617
Bad debt30000026400036000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total6416Total
Program Services5594ProgramServices
Management And General822ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5641591Total
Program Services4982008ProgramServices
Management And General659583ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY104BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1203887BOY
EOY970647EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1404166BOY
EOY1135709EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY163674BOY
EOY130623EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY55602BOY
EOY123387EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis7677904LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4066811LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3746845BOY
EOY3611093EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY481417BOY
EOY549993EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY553373BOY
EOY553646EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7609068BOY
EOY7075098EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY35247BOY
EOY126587EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY256000BOY
EOY234822EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY268361BOY
EOY271235EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY559608BOY
EOY632644EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6512637BOY
EOY5903164EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY536823BOY
EOY539290EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7049460BOY
EOY6442454EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7609068BOY
EOY7075098EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1552585CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1250894CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1824071CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1521801CurrentTaxYearMinus1Year
Current Tax Year1843360CurrentTaxYear
Total7992711Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3703570CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3559887CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4112574CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4125288CurrentTaxYearMinus1Year
Current Tax Year3093690CurrentTaxYear
Total18595009Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5256155CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4810781CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5936645CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5647089CurrentTaxYearMinus1Year
Current Tax Year4937050CurrentTaxYear
Total26587720Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50926587720PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65655CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years83115CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years84620CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year54127CurrentTaxYearMinus1Year
Current Tax Year24779CurrentTaxYear
Total312296Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65655CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years83115CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years84620CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year54127CurrentTaxYearMinus1Year
Current Tax Year24779CurrentTaxYear
Total312296Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years52185CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years69193CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years79215CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80418CurrentTaxYearMinus1Year
Current Tax Year72756CurrentTaxYear
Total353767Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total27253783Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97560PublicSupportPercentage509
Prior Year Support Percentage0.97400PriorYearSupportPercentage
Investment Income Percentage0.01150InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01300PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationIn prior years the organization has reported as a hospital on Schedule A and has filed a Schedule H. After consideration of the facts and financial data, it has been determined that the categorization on the original determination letter received in 1975 does not accurately reflect the organization's circumstances. This year and moving forward the organization is filing as a public support organization and has filed a Schedule A with a completed Part III as required.GeneralExplanation

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 Basis44991OtherCostOrOtherBasis
Book Value44991BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6337252OtherCostOrOtherBasis
Depreciation3168635Depreciation
Book Value3168617BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1295661OtherCostOrOtherBasis
Depreciation898176Depreciation
Book Value397485BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3611093TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Unconditional promise to give496340
Restricted by donors42950
Deposits14356
FieldValueIRS element (for citing)
Total Book Value Other Assets553646TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Patient refunds payable$42,638
Accrued expenses$228,597
FieldValueIRS element (for citing)
Total Of Amounts271235TotalOfAmounts
Total Revenue5034585TotalRevenue
Total Expenses5641591TotalExpenses
Excess Or Deficit For Year-607006ExcessOrDeficitForYear
Excess Or Deficit Per FS-607006ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt5034585TotRevenueEtcAuditedFinclStmt
Revenue Subtotal5034585RevenueSubtotal
Total Revenue Per Form9905034585TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5641591TotExpensesEtcAuditedFinclStmt
Expenses Subtotal5641591ExpensesSubtotal
Total Expenses Per Form9905641591TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredfalseSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonHeidi BainesNamePerson
Base Compensation Filing Org118462BaseCompensationFilingOrg
Bonus Filing Org3700BonusFilingOrg
Other Compensation Filing Org28186OtherCompensationFilingOrg
Total Compensation Filing Org150348TotalCompensationFilingOrg

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 1bIdentifier
Return ReferencePart I, Line 1b: Reason for not following policy regarding payment provisions for expensesReturnReference
ExplanationNone of these items were provided for the employee and so no written policy exists.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe governing documents, Board-code of ethics, and grievance policy are made available to the public upon request. The organization's monthly financial statements are made available to the public at the Board of Directors' Monthly meetings.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe Board of Directors does an internal monitoring of each members associations and relationships so that no member is in a decision making process that can be unduly influenced through a prior relationship.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessThe completed 990 is sent to the Board via email, they then meet as a body and review the report either in a regular session of a specially called session.

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