PORTAGE PATH COMMUNITY MENTAL HEALTH CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- PORTAGE PATH COMMUNITY MENTAL HEALTH CENTER (EIN 34-1096055)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-02-04
- IRS object ID
- 202110359349300011
- Schema version
- 2019v5.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-02-04T10:10:56-06:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363168081 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIKICH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 274 WHITE POND DRIVE | AddressLine1Txt |
| City | AKRON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 443201118 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341096055 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTAGE PATH BEHAVIORAL HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PORT | BusinessNameControlTxt |
| Phone | 3302533100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 340 S BROADWAY STREET | AddressLine1Txt |
| City | AKRON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44308 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TRACY D YAEGER PHD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3302533100 | PhoneNum |
| Signature | 2021-02-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JILL M BOYLE CPA | PreparerPersonNm |
| PTIN | P01246734 | PTIN |
| Phone | 3308646661 | PhoneNum |
| Preparation | 2021-02-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TRACY D YAEGER PHD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 340 S BROADWAY STREET | AddressLine1Txt |
| City | AKRON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,136,023 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PORTAGEPATH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1968 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | THE AGENCY PROVIDES MENTAL HEALTH SERVICES FOR ADULTS IN SUMMIT COUNTY, OHIO. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 182 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $3,418 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $2,418 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $59,237 | PYContributionsGrantsAmt |
| CY Contributions Grants | $353,904 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,778,716 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,661,202 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $476 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,848 | PYOtherRevenueAmt |
| CY Other Revenue | $113,387 | CYOtherRevenueAmt |
| PY Total Revenue | $5,857,801 | PYTotalRevenueAmt |
| CY Total Revenue | $12,128,969 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $15,290 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $70,961 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,968,186 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,384,935 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,871,665 | PYOtherExpensesAmt |
| CY Other Expenses | $2,935,843 | CYOtherExpensesAmt |
| PY Total Expenses | $5,855,141 | PYTotalExpensesAmt |
| CY Total Expenses | $12,391,739 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,660 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$262,770 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,844,525 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,262,602 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,921,874 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,602,721 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $922,651 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $659,881 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE AGENCY PROVIDES MENTAL HEALTH SERVICES FOR ADULTS IN SUMMIT COUNTY, OHIO. THE AGENCY HELPS ADULTS WORK THROUGH AND COPE WITH BEHAVIORAL AND EMOTIONAL PROBLEMS USING THERAPY, GROUP PROGRAMS, AND MEDICATION WHEN NECESSARY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,765,108 | ExpenseAmt |
| Grant | $70,961 | GrantAmt |
| Revenue | $3,860,279 | RevenueAmt |
| Desc | PHARMACOLOGICAL MANAGEMENT - CLIENTS WITH NEED FOR PSYCHOTROPIC MEDICATIONS AND MONITORING OF ONGOING MEDICAL CARE TO MAINTAIN STABILITY AND SYMPTOM IMPROVEMENT. 07/01/2019-06/30/2020 3,108 CLIENTS SERVED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,465,909 | ExpenseAmt |
| Revenue | $2,528,240 | RevenueAmt |
| Desc | RESIDENTIAL TREATMENT - A SHORT-TERM RESIDENTIAL ENVIRONMENT WHERE CLIENTS ARE MONITORED AND TREATED FOR UP TO 14 DAYS TO MANAGE THE CRISIS IN THE MOST EFFECTIVE MANNER. 07/01/2019-06/30/2020 220 CLIENTS SERVED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,772,616 | ExpenseAmt |
| Revenue | $1,817,423 | RevenueAmt |
| Desc | INDIVIDUAL COUNSELING - CLIENT AND FAMILY THERAPY UTILIZING A VARIETY OF TREATMENT MODALITIES AND APPROACHES TO PROVIDE CLIENTS WITH MAXIMUM TREATMENT BENEFIT. THERAPY SESSIONS FOCUS ON URGENT CRISIS ORIENTED CLIENT PROBLEMS AND SITUATIONS. 07/01/2019-06/30/2020 2,135 CLIENTS SERVED | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,347,855 | ExpenseAmt |
| Revenue | $3,559,511 | RevenueAmt |
| Desc | OTHER PROGRAMS INCLUDE CRISIS INTERVENTION, DIAGNOSTIC ASSESSMENTS, GROUP COUNSELING, A CALL-IN HOTLINE, AND OTHER ANCILLARY SERVICES. 07/01/2019-06/30/2019 3,755 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $3,347,855 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,559,511 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $11,351,488 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 182 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHILLIP HEISLMAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3302533100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 340 S BROADWAY STREET | AddressLine1Txt |
| City | AKRON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44308 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| GABRIELA FEIER | ||||||||
| MD | 40.00 | Yes (X) | $299,941 | $0 | $27,410 | |||
| MARILENA ACHIM | ||||||||
| MD | 40.00 | Yes (X) | $230,208 | $0 | $22,460 | |||
| CAROL LEWIS | ||||||||
| MD | 40.00 | Yes (X) | $155,869 | $0 | $11,228 | |||
| YUAN-HUA THAKORE | ||||||||
| MD | 40.00 | Yes (X) | $136,768 | $0 | $10,715 | |||
| TRACY YAEGER | ||||||||
| PRESIDENT | 40.00 | $128,053 | $0 | $11,571 | Yes (X) | |||
| MICHAEL KESSELRING | ||||||||
| PMHNP-BC | 40.00 | Yes (X) | $114,499 | $0 | $23,787 | |||
| PHILLIP HEISLMAN | ||||||||
| SENIOR VP/CFO | 37.00 | $97,277 | $0 | $27,417 | Yes (X) | 3.00 | ||
| SEAN BLAKE | ||||||||
| VICE-PRESIDENT CLINICAL | 40.00 | $71,077 | $0 | $11,058 | Yes (X) | |||
| DIANE GILGER | ||||||||
| VICE CHAIRMAN | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| RALPH WILLIAM MCCUE MD | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| JOHN ZOILO | ||||||||
| CHAIRMAN | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| ERNEST ARANYOSI CPA | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| CARLA L CHAPMAN | ||||||||
| TREASURER | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| HEATHER BARNES | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ROBERT COOPER | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| LINDA SUBICH PHD | ||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| MICHAEL THOMAS | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| SANDRA DICKSON | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| CHRISTOPHER ECK | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ANNE MERCHANT | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,233,692 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $145,646 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AMERICAN MEDICAL PERSONNEL | |||||
| 1428 EDISON ST NW | HARTVILLE | OH | 44632 | TEMP STAFFING | $469,350 |
| ATNET PLUS | |||||
| 1000 CAMPUS DR 700 | STOW | OH | 44224 | IT | $166,476 |
| NETSMART TECHNOLOGIES | |||||
| PO BOX 823519 | PHILADELPHIA | PA | 19182 | IT | $138,334 |
| OFFICETEAM | |||||
| 12400 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | TEMP STAFFING | $136,273 |
| JEFFREY MOORE MD | |||||
| 4826 RANCHWOOD RD | AKRON | OH | 44333 | MEDICAL DIRECTOR | $109,090 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $7,080 | FundraisingAmt |
| Related Organizations | $25,488 | RelatedOrganizationsAmt |
| All Other Contributions | $321,336 | AllOtherContributionsAmt |
| Noncash Contributions | $70,961 | NoncashContributionsAmt |
| Total Contributions | $353,904 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| FEES FROM GOVERNMENTAL | 621400 | $6,101,864 | $6,101,864 |
| MEDICARE/MEDICAID PAYMENTS | 621400 | $4,629,603 | $4,629,603 |
| PATIENT FEES | 621400 | $929,735 | $929,735 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,661,202 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $476 | TotalRevenueColumnAmt |
| Exclusion | $476 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $12,772 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $7,080 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,054 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,718 | TotalRevenueColumnAmt |
| Exclusion | $5,718 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $107,669 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $104,251 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $3,418 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $107,669 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,128,969 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,765,453 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $3,418 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,194 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,961 | TotalAmt |
| Program Services | $70,961 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,103 | TotalAmt |
| Program Services | $334,781 | ProgramServicesAmt |
| Management And General | $35,322 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,326,611 | TotalAmt |
| Program Services | $6,616,994 | ProgramServicesAmt |
| Management And General | $709,617 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,913 | TotalAmt |
| Program Services | $236,900 | ProgramServicesAmt |
| Management And General | $23,013 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $944,932 | TotalAmt |
| Program Services | $861,267 | ProgramServicesAmt |
| Management And General | $83,665 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,376 | TotalAmt |
| Program Services | $432,787 | ProgramServicesAmt |
| Management And General | $50,589 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,199 | TotalAmt |
| Program Services | $14,839 | ProgramServicesAmt |
| Management And General | $1,360 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,180 | TotalAmt |
| Program Services | $42,303 | ProgramServicesAmt |
| Management And General | $3,877 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $922,102 | TotalAmt |
| Program Services | $920,220 | ProgramServicesAmt |
| Management And General | $1,882 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,468 | TotalAmt |
| Program Services | $99,183 | ProgramServicesAmt |
| Management And General | $9,285 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,087 | TotalAmt |
| Program Services | $289,552 | ProgramServicesAmt |
| Management And General | $26,535 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,432 | TotalAmt |
| Program Services | $238,571 | ProgramServicesAmt |
| Management And General | $10,861 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,205 | TotalAmt |
| Program Services | $93,467 | ProgramServicesAmt |
| Management And General | $1,738 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,605 | TotalAmt |
| Program Services | $89,773 | ProgramServicesAmt |
| Management And General | $1,832 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,769 | TotalAmt |
| Program Services | $310,100 | ProgramServicesAmt |
| Management And General | $30,669 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,673 | TotalAmt |
| Program Services | $164,590 | ProgramServicesAmt |
| Management And General | $15,083 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $225,265 | $213,525 | $11,740 |
| REPAIRS/MAINTENANCE/FUR | $209,210 | $195,541 | $13,669 |
| MISCELLANEOUS | $95,435 | $87,423 | $8,012 |
| MEDICINE AND PERSONAL H | $22,318 | $22,318 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,895 | TotalAmt |
| Program Services | $16,393 | ProgramServicesAmt |
| Management And General | $1,502 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,391,739 | TotalAmt |
| Program Services | $11,351,488 | ProgramServicesAmt |
| Management And General | $1,040,251 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $696 | BOYAmt |
| EOY | $695 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,864 | BOYAmt |
| EOY | $1,835,087 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,558,583 | BOYAmt |
| EOY | $1,010,944 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,274 | BOYAmt |
| EOY | $92,377 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,484,234 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,175,065 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $947,370 | BOYAmt |
| EOY | $2,309,169 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,738 | BOYAmt |
| EOY | $14,330 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,844,525 | BOYAmt |
| EOY | $5,262,602 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,665,582 | BOYAmt |
| EOY | $1,424,666 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,008 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,284 | BOYAmt |
| EOY | $1,649,555 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,528,500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,921,874 | BOYAmt |
| EOY | $4,602,721 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $809,096 | BOYAmt |
| EOY | $470,176 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,555 | BOYAmt |
| EOY | $189,705 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $922,651 | BOYAmt |
| EOY | $659,881 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,844,525 | BOYAmt |
| EOY | $5,262,602 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$262,770 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $116,429 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $111,166 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $246,442 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,237 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $353,904 | CurrentTaxYearAmt |
| Total | $887,178 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $116,429 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $111,166 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $246,442 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,237 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $353,904 | CurrentTaxYearAmt |
| Total | $887,178 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $230,980 | SubstantialContributorsTotAmt |
| Public Support Total170 | $656,198 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $476 | CurrentTaxYearAmt |
| Total | $477 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $3,418 | CurrentTaxYearAmt |
| Total | $3,418 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $48,369 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,449 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $125,493 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,164 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $109,969 | CurrentTaxYearAmt |
| Total | $334,444 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,225,517 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $51,905,241 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.53540 | PublicSupportCY170Pct |
| Public Support PY170 | 0.75880 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | OTHER INCOME - 2015 AMOUNT: $ 48,369. 2016 AMOUNT: $ 30,449. 2017 AMOUNT: $ 125,493. 2018 AMOUNT: $ 20,164. 2019 AMOUNT: $ 104,251. FUNDRAISING INCOME - 2015 AMOUNT: $ 0. 2016 AMOUNT: $ 0. 2017 AMOUNT: $ 0. 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 5,718. |
| SCHEDULE A, PART II, SHORT-YEAR RETURN | THE ORGANIZATION FILED A SHORT-YEAR 2019 RETURN FOR THE TAX PERIOD 1/1/19-6/30/19. THE REVENUE FOR THE PUBLIC SUPPORT TEST IN PART II FROM THIS SHORT-YEAR RETURN IS BEING REPORTED IN THE "2018" COLUMN. THE REVENUE FROM THE THREE RETURNS PRIOR TO THIS SHORT-YEAR RETURN ARE REPORTED IN THE 2017-2015 COLUMNS FROM RIGHT TO LEFT IN DECENDING ORDER OF THE YEAR THEY WERE FILED (NEWEST TO OLDEST). |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,111,742 | OtherCostOrOtherBasisAmt |
| Depreciation | $930,066 | DepreciationAmt |
| Book Value | $2,181,676 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,372,492 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,244,999 | DepreciationAmt |
| Book Value | $127,493 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,309,169 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDABLE ADVANCE | Desc |
| Amt | $1,528,500 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,528,500 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,151,189 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $22,220 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $22,220 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,128,969 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,128,969 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,413,959 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $22,220 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $22,220 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,391,739 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,391,739 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE AGENCY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE AGENCY HAS NOT RECORDED PROVISIONS FOR FEDERAL AND STATE INCOME TAXES. THE AGENCY IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | 5K RACE | Event1Nm |
| Gross Receipts Event1 | $19,852 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $7,080 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $12,772 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $631 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $128 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $6,295 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $19,852 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $7,080 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $12,772 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $631 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $128 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $6,295 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,054 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $5,718 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | FINANCIAL ASSISTANCE FROM STATE CENTRAL PHARMACY | GrantTypeTxt |
| Recipient | 360 | RecipientCnt |
| Non Cash Assistance | $70,961 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | PRESCRIPTION MEDICATION | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MONITORING THROUGH PAYROLL FOR RECIPIENTS WHO ARE ON STAFF AND VIA ACCOUNTS PAYABLE FOR ALL OTHERS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GABRIELA FEIER | ||||||||||||||
| MD | $299,941 | $0 | $0 | $0 | $0 | $0 | $7,134 | $0 | $20,276 | $0 | $327,351 | $0 | $0 | $0 |
| MARILENA ACHIM | ||||||||||||||
| MD | $230,208 | $0 | $0 | $0 | $0 | $0 | $19,370 | $0 | $3,090 | $0 | $252,668 | $0 | $0 | $0 |
| CAROL LEWIS | ||||||||||||||
| MD | $155,869 | $0 | $0 | $0 | $0 | $0 | $3,724 | $0 | $7,504 | $0 | $167,097 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION IS DETERMINED THROUGH APPROVAL BY THE BOARD OF TRUSTEES. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 360 | ContributionCnt |
| Noncash Contributions Rpt F990 | $70,961 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE SENIOR VICE PRESIDENT/CFO, FINANCE COMMITTEE, AND THE BOARD OF TRUSTEES REVIEW THE FORM 990 BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS RECEIVE A COPY OF THE CONFLICT OF INTEREST FORM ANNUALLY TO UPDATE AS NEEDED. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION FOR THE PRESIDENT REQUIRES A REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NORTHEAST OHIO PSYCHIATRIC INSTITUTE | ||||||||||
| 340 SOUTH BROADWAY STREET | AKRON | OH | 44308 | 341501286 | SUPPORTING ORGANIZATION TO PORTAGE PATH BEHAVIORAL HEALTH | OH | 501(C)(3) | LINE 12A, I | PORTAGE PATH BEHAVIORAL HEALTH | Yes (1) |
| PRISM HEALTH LLC | ||||||||||
| 75 EAST MARKET STREET | AKRON | OH | 44308 | 273120098 | SUPPORTING ORGANIZATIN TO PORTAGE PATH BEHAVIORAL HEALTH | OH | 501(C)(3) | LINE 10 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTHEAST OHIO PSYCHIATRIC INSTITUTE | ||
| C | $25,488 | FMV |
| NORTHEAST OHIO PSYCHIATRIC INSTITUTE | ||
| E | $161,315 | FMV |
| NORTHEAST OHIO PSYCHIATRIC INSTITUTE | ||
| E | $80,000 | FMV |
| NORTHEAST OHIO PSYCHIATRIC INSTITUTE | ||
| K | $122,397 | FMV |
| NORTHEAST OHIO PSYCHIATRIC INSTITUTE | ||
| M | $1,062,223 | FMV |