NORTH CAROLINA HEALTHCARE FOUNDATION INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- NORTH CAROLINA HEALTHCARE FOUNDATION INC (EIN 56-0773039)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-08-28
- IRS object ID
- 202022419349301207
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-28T11:26:11-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560773039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA HEALTHCARE FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 9196772400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4449 | AddressLine1Txt |
| City | CARY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27519 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN J LAWLER | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 9196772400 | PhoneNum |
| Signature | 2020-08-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2020-08-27 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-27 | IPDt |
| IP Tm | 06:08:46 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0FA37CE34EDFE58DB410E6F490D69C2898079F18 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CEA045B55A74C437D2AB286F4B0AF1DA82127741 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-11-19 02:30:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHEN J LAWLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4449 | AddressLine1Txt |
| City | CARY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27519 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,314,113 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | NCHA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO FOSTER AND ACCELERATE THE COLLECTIVE IMPACT OF HOSPITALS, HEALTH SYSTEMS AND COMMUNITY PARTNERS TO IMPROVE THE HEALTH OF NORTH CAROLINIANS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,299,952 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,008,294 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $721,413 | CYProgramServiceRevenueAmt |
| PY Investment Income | $195,702 | PYInvestmentIncomeAmt |
| CY Investment Income | $143,416 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,495,654 | PYTotalRevenueAmt |
| CY Total Revenue | $5,873,123 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $873,896 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,817,387 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $945,437 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,782,823 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,597,538 | PYOtherExpensesAmt |
| CY Other Expenses | $1,903,075 | CYOtherExpensesAmt |
| PY Total Expenses | $3,416,871 | PYTotalExpensesAmt |
| CY Total Expenses | $5,503,285 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,078,783 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $369,838 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,284,607 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,804,352 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,232,155 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,577,357 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,052,452 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,226,995 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO FOSTER AND ACCELERATE THE COLLECTIVE IMPACT OF HOSPITALS, HEALTH SYSTEMS AND COMMUNITY PARTNERS TO IMPROVE THE HEALTH OF NORTH CAROLINIANS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,983,281 | ExpenseAmt |
| Grant | $1,817,387 | GrantAmt |
| Revenue | $721,413 | RevenueAmt |
| Desc | THE NORTH CAROLINA HOSPITAL FOUNDATION CARRIES OUT ACTIVITIES THAT FOSTER AND ACCELERATE THE COLLECTIVE IMPACT OF HOSPITALS, HEALTH SYSTEMS AND COMMUNITY PARTNERS TO IMPROVE THE HEALTH OF NORTH CAROLINIANS. | Desc |
| Total Program Service Expenses | $4,983,281 | 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 | Yes (1) | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | 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 | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFREY WEEGAR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9196774231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 WESTON PARKWAY | AddressLine1Txt |
| City | CARY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27513 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| STEPHEN J LAWLER | |||||||
| PRESIDENT | 7.50 | 30.00 | Yes (X) | Yes (X) | $0 | $784,957 | $49,175 |
| TERRY AKIN | |||||||
| BOARD CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BLAIR CHILDS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL CUNNINGHAM MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VANESSA ERVIN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG GOMBAR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LIN HOLLOWELL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHUCK MANTOOTH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEAH MCCALL DEVLIN DDS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALLEN SMART | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CASSIUS WILLIAMS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIA WACKER | |||||||
| VICE PRESIDENT | 37.50 | Yes (X) | $0 | $180,702 | $13,409 | ||
| JEFFREY WEEGAR | |||||||
| VP FIN. POLICY/CFO | 7.50 | 30.00 | Yes (X) | $0 | $165,914 | $18,214 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,131,573 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $80,798 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TSNE MISSIONWORKS | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 88 SOUTH STREET STUIE 700 | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02111 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CONSULTING SERVICES | ServicesDesc |
| Compensation | $159,538 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,557,436 | GovernmentGrantsAmt |
| All Other Contributions | $2,450,858 | AllOtherContributionsAmt |
| Total Contributions | $5,008,294 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEETING REGISTRATION | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $721,413 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $721,413 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $721,413 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $141,742 | TotalRevenueColumnAmt |
| Exclusion | $141,742 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,442,664 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,440,990 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,674 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,674 | TotalRevenueColumnAmt |
| Exclusion | $1,674 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,873,123 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $721,413 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $143,416 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,817,387 | TotalAmt |
| Program Services | $1,817,387 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,429,441 | TotalAmt |
| Program Services | $1,290,118 | ProgramServicesAmt |
| Management And General | $139,323 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,948 | TotalAmt |
| Program Services | $45,080 | ProgramServicesAmt |
| Management And General | $4,868 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,678 | TotalAmt |
| Program Services | $179,313 | ProgramServicesAmt |
| Management And General | $19,365 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,756 | TotalAmt |
| Program Services | $94,546 | ProgramServicesAmt |
| Management And General | $10,210 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,556 | TotalAmt |
| Program Services | $331,319 | ProgramServicesAmt |
| Management And General | $168,237 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,931 | TotalAmt |
| Management And General | $34,931 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,833 | TotalAmt |
| Program Services | $414,833 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,936 | TotalAmt |
| Program Services | $5,936 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,831 | TotalAmt |
| Program Services | $1,873 | ProgramServicesAmt |
| Management And General | $2,958 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,433 | TotalAmt |
| Program Services | $155,355 | ProgramServicesAmt |
| Management And General | $72,078 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,669 | TotalAmt |
| Program Services | $176,134 | ProgramServicesAmt |
| Management And General | $49,535 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,411 | TotalAmt |
| Program Services | $41,147 | ProgramServicesAmt |
| Management And General | $6,264 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423,886 | TotalAmt |
| Program Services | $422,508 | ProgramServicesAmt |
| Management And General | $1,378 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,658 | TotalAmt |
| Management And General | $4,658 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,197 | TotalAmt |
| Management And General | $3,197 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES, SUBSCRIPTIONS, ET | $7,732 | $7,732 | |
| GENERAL & ADMIN | $3,002 | $3,002 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,503,285 | TotalAmt |
| Program Services | $4,983,281 | ProgramServicesAmt |
| Management And General | $520,004 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,501,730 | BOYAmt |
| EOY | $2,512,953 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,517 | BOYAmt |
| EOY | $434,383 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,557 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,557 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,658 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,479,202 | BOYAmt |
| EOY | $3,857,016 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,284,607 | BOYAmt |
| EOY | $6,804,352 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,741 | BOYAmt |
| EOY | $379,568 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $165,984 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $902,414 | BOYAmt |
| EOY | $1,031,805 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,232,155 | BOYAmt |
| EOY | $1,577,357 | 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 | $830,947 | BOYAmt |
| EOY | $1,047,409 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,221,505 | BOYAmt |
| EOY | $4,179,586 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,052,452 | BOYAmt |
| EOY | $5,226,995 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,284,607 | BOYAmt |
| EOY | $6,804,352 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $369,838 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $277,317 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$472,612 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,163,940 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,834,711 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,595,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,299,952 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,008,294 | CurrentTaxYearAmt |
| Total | $24,902,087 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $721,413 | CurrentTaxYearAmt |
| Total | $721,413 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,163,940 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,834,711 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,595,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,299,952 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,729,707 | CurrentTaxYearAmt |
| Total | $25,623,500 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $25,623,500 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $115,886 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $131,529 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $133,417 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $137,147 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $141,742 | CurrentTaxYearAmt |
| Total | $659,721 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $115,886 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $131,529 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $133,417 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $137,147 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $141,742 | CurrentTaxYearAmt |
| Total | $659,721 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,279,826 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,966,240 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,728,607 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,437,099 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,871,449 | CurrentTaxYearAmt |
| Total | $26,283,221 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97490 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97930 | PublicSupportPY509Pct |
| Investment Income CY | 0.02510 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02070 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $49,557 | OtherCostOrOtherBasisAmt |
| Depreciation | $49,557 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATE | $974,001 |
| ACCRUED COMPENSATION | $57,804 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,031,805 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,150,440 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $277,317 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $277,317 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,873,123 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,873,123 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,503,285 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,503,285 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,503,285 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE FOUNDATION FOLLOWS THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2019. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (29 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| GRANVILLE HEALTH INC | |||||||
| PO BOX 947 | OXFORD | NC | 27565 | 264073395 | 509(A)(1) | $16,599 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| TRUVEN HEALTH ANALYTICS IBM WATSON HEALTH | |||||||
| 1 N DEARBORN ST 1400 | CHICAGO | IL | 60602 | 130871925 | $7,625 | EMERGENCY DEPARTMENT DATABASE INITIATIVE | |
| LIFEBRITE COMMUNITY HOSPITAL OF STOKES | |||||||
| 1570 NC 8 89 HWY NORTH | DANBURY | NC | 27016 | 561793620 | $13,278 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM | |
| SOUTHEASTERN REGIONAL MEDICAL CENTER | |||||||
| PO BOX 1408 | LUMBERTON | NC | 28359 | 560530233 | 509(A)(1) | $136,936 | NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM |
| EAST CAROLINA HEALTH-BEAUFORT INC (VIDANT BEAUFORT HOSPITAL) | |||||||
| 628 E 12TH STREET | WASHINGTON | NC | 27889 | 452436270 | 509(A)(1) | $5,118 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| ALLEGHANY COUNTY MEMORIAL HOSPITAL INC | |||||||
| PO BOX 947 | SPARTA | NC | 28675 | 560525657 | 509(A)(1) | $7,029 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| CHATHAM HOSPITAL INC | |||||||
| PO BOX 649 | SILER CITY | NC | 27344 | 560611546 | 509(A)(1) | $6,753 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| UNC HEALTH CARE SYSTEM | |||||||
| 211 FRIDAY CENTER DRIVE SUITE 2108 | CHAPEL HILL | NC | 27517 | 562206970 | $163,378 | NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM | |
| CHOWAN INC (VIDANT CHOWAN HOSPITAL) | |||||||
| 211 VIRGINIA ROAD | EDENTON | NC | 27932 | 562101090 | 509(A)(1) | $12,327 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 510190238 | 509(A)(3) | $188,798 | NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM |
| CAPE FEAR VALLEY HOKE HEALTHCARE | |||||||
| 210 MEDICAL PAVILION DRIVE | RAEFORD | NC | 28376 | 560845796 | 509(A)(1) | $26,999 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| NOVANT HEALTH FOUNDATION PRESBYTERIAN MEDICAL CENTER | |||||||
| 200 HAWTHORNE LANE BELK HOUSE | CHARLOTTE | NC | 28204 | 581413074 | 509(A)(1) | $53,324 | NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM |
| CONE HEALTH BEHAVIORAL HEALTH HOSPITAL | |||||||
| 1200 N ELM STREET | GREENSBORO | NC | 27401 | 560532302 | 509(A)(1) | $132,776 | NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM |
| ATRIUM HEALTH FOUNDATION | |||||||
| 208 EAST BLVD | CHARLOTTE | NC | 28203 | 566060481 | 509(A)(2) | $93,028 | NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM |
| J ARTHUR DOSHER MEMORIAL HOSPITAL | |||||||
| 924 N HOWE ST | SOUTHPORT | NC | 28461 | 560845824 | 509(A)(1) | $11,450 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| VIDANT BERTIE HOSPITAL | |||||||
| 1403 SOUTH KING ST | WINDSOR | NC | 279839666 | 562003393 | 509(A)(1) | $12,327 | SMALL RURAL HEALTH IMPROVEMENT PROGRAM |
| FIRST HEALTH MONTGOMERY MEMORIAL HOSPITAL | |||||||
| 520 ALLEN STREET | TROY | NC | 27932 | 561936354 | 509(A)(1) | $13,170 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| ASHE MEMORIAL HOSPITAL | |||||||
| 200 HOSPITAL AVE | JEFFERSON | NC | 28640 | 560603900 | 509(A)(1) | $14,567 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| CHARLES A CANNON JR MEMORIAL HOSPITAL | |||||||
| PO BOX 767 | LINVILLE | NC | 28646 | 560529974 | 509(A)(1) | $5,700 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| PERSON MEMORIAL HOSPITAL | |||||||
| 615 RIDGE ROAD | ROXBORO | NC | 27573 | 560543247 | 509(A)(1) | $8,000 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| MARTIN GENERAL HOSPITAL | |||||||
| 310 S MCCASKEY ROAD | WILLIAMSTON | NC | 27892 | 999999999 | 509(A)(1) | $7,062 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| ERLANGER WESTERN CAROLINA HOSPITAL | |||||||
| 3990 E HWY 64 ALT | MURPHY | NC | 28906 | 561844262 | 509(A)(1) | $11,624 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| PENDER MEMORIAL HOSPITAL | |||||||
| 507 E FREMONT ST | BURGAW | NC | 28425 | 560653348 | 509(A)(1) | $8,281 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| MISSION DEPARTMENT OF PHILANTHROPY | |||||||
| 890 HENDERSONVILLE ROAD SUITE 300 | ASHEVILLE | NC | 28803 | 561881331 | $55,933 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM | |
| FIRST HEALTH MOORE REGIONAL HOSPITAL - HOKE CAMPUS | |||||||
| 6408 FAYETTEVILLE RD | RAEFORD | NC | 28376 | 561936354 | 509(A)(1) | $16,599 | SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM |
| J ARTHUR DOSHER MEMORIAL HOSPITAL | |||||||
| 924 N HOWE ST | SOUTHPORT | NC | 28461 | 560845824 | 509(A)(1) | $183,605 | HURRICANE FLORENCE RECOVERY GRANT |
| SOUTHEASTERN REGIONAL MEDICAL CENTER | |||||||
| PO BOX 1408 | LUMBERTON | NC | 28359 | 560530233 | 509(A)(1) | $86,949 | HURRICANE FLORENCE RECOVERY GRANT |
| CAROLINAEAST MEDICAL CENTER | |||||||
| PO BOX 12157 2000 NEUSE BLVD | NEW BERN | NC | 28561 | 562649056 | 509(A)(1) | $125,000 | HURRICANE FLORENCE RECOVERY GRANT |
| CARTERET GENERAL HOSPITAL | |||||||
| 3500 ARENDELL ST | MOREHEAD CITY | NC | 28557 | 560884724 | 509(A)(1) | $104,446 | HURRICANE FLORENCE RECOVERY GRANT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 26 | Total501c3OrgCnt |
| Total Other Org | 3 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL GRANTS RECEIVED BY NCHF ARE GOVERNED BY CONTRACTS WITH THE GRANTOR WHICH OUTLINE GRANT TERMS AND CONDITIONS INCLUDING DETAILED MONITORING, REPORTING, PERFORMANCE AND PAYMENT REQUIREMENTS. FOR ANY GRANT THAT INVOLVES A SUB-AWARD, OR RE-GRANTING OF FUNDS TO ANOTHER ORGANIZATION TO PERFORM A BODY OF WORK UNDER THE PRIMARY GRANT, NCHF COLLECTS APPLICATIONS AND EXECUTES DETAILED CONTRACTS WITH SUB-AWARD RECIPIENTS. EACH NCHF GRANT HAS AN ASSIGNED PROGRAM LEAD WHO IS RESPONSIBLE FOR PROVIDING PROGRAM OVERSIGHT TO ENSURE THAT ALL CONTRACT EXPECTATIONS ARE MET AND THAT ALL SUB-AWARD RECIPIENTS ARE ALSO MEETING THEIR CONTRACT OBLIGATIONS. NCHF DIRECTOR OF OPERATIONS ALSO HAS BUDGET OVERSIGHT OF ALL GRANT CONTRACTS AND ENSURES COMPLIANCE WITH CONTRACT TERMS AND CONDITIONS. GRANT SUB-AWARD RECIPIENTS MUST PRODUCE PERFORMANCE REPORTS AND DETAILED INVOICES, WITH SUPPORTING DOCUMENTATION, IN ORDER TO RECEIVE GRANT FUNDS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHEN J LAWLER | ||||||||||||||
| PRESIDENT | $0 | $592,457 | $0 | $192,500 | $0 | $0 | $0 | $37,500 | $0 | $11,675 | $0 | $834,132 | $0 | $0 |
| JULIA WACKER | ||||||||||||||
| VICE PRESIDENT | $0 | $150,702 | $0 | $30,000 | $0 | $0 | $0 | $3,774 | $0 | $9,635 | $0 | $194,111 | $0 | $0 |
| JEFFREY WEEGAR | ||||||||||||||
| VP FIN. POLICY/CFO | $0 | $150,026 | $0 | $15,888 | $0 | $0 | $0 | $8,579 | $0 | $9,635 | $0 | $184,128 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE EXECUTIVE COMPENSATION COMMITTEE OF THE NCHA, INC., A RELATED ORGANIZATION, REVIEWS THE COMPENSATION OF THE PRESIDENT AND OTHER KEY EXECUTIVES. IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THE EXECUTIVE COMPENSATION COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. |
| PART I, LINE 4B | A RELATED ORGANIZATION MAINTAINS A NON-QUALIFIED RETENTION BENEFIT PLAN UNDER SECTION 457(F) COVERING FIVE KEY EMPLOYEES. THE COVERED EMPLOYEES RECEIVE AN ANNUAL BENEFIT EQUAL TO A CERTAIN PERCENTAGE OF THEIR ORDINARY SALARY. THE PARTICIPANTS CAN ELECT TO INVEST THEIR ANNUAL BENEFIT IN A CAPITAL ACCUMULATION ACCOUNT OR CHOOSE OTHER FRINGE BENEFITS. FOR THE CURRENT YEAR, THE ORGANIZATION ACCRUED $25,000 TO THE PLAN FOR STEPHEN J. LAWLER. THIS AMOUNT IS INCLUDED IN SCHEDULE J, PART II. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE POWER AND AUTHORITY OF THE CORPORATION SHALL BE VESTED IN ITS BOARD OF TRUSTEES WHICH SHALL HAVE NOT LESS THAN TEN MEMBERS, CONSISTING OF HEALTHCARE, COMMUNITY, PHILANTHROPIC, FINANCIAL, AND CORPORATE LEADERS. ALL MEMBERS SHALL BE APPOINTED BY THE BOARD OF TRUSTEES OF NCHA, INC. AT LEAST TWO MEMBERS WILL ALSO SERVE ON THE BOARD OF TRUSTEES OF NCHA, INC. EACH MEMBER SHALL SERVE A THREE-YEAR TERM. A MEMBER MAY SERVE NO MORE THAN TWO FULL CONSECUTIVE TERMS. THE INITIAL TERMS BEGINNING IN 2019 SHALL BE STAGGERED SO THAT APPROXIMATELY ONE-THIRD OF THE TERMS EXPIRE IN 2020, ONE THIRD IN 2021, AND ONE-THIRD IN 2022. THE BOARD OF TRUSTEES OF NCHA, INC. SHALL ALSO FILL ANY VACANCY FOR THE UNEXPIRED TERM. |
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT COPY OF THE 990 WAS SUBMITTED TO THE FOUNDATION BOARD FOR REVIEW PRIOR TO THE FORM 990 BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST POLICY ANNUALLY DISCLOSING ANY POSSIBLE CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMPENSATION COMMITTEE OF NCHA, INC., A RELATED ORGANIZATION, WILL ANNUALLY MONITOR AND REVIEW EXECUTIVE COMPENSATION AND BENEFIT PROGRAMS, IN AGGREGATE, TO ENSURE CONSISTENCY WITH THE OVERALL COMPENSATION PHILOSOPHY AND GUIDING PRINCIPLES AND OBJECTIVES. AT ITS DISCRETION, THE EXECUTIVE COMPENSATION COMMITTEE MAY DELEGATE "DAY TO DAY" RESPONSIBILITY TO ADMINISTER COMPENSATION AND BENEFIT PROGRAMS TO NCHA'S PRESIDENT FOR ALL OTHER EXECUTIVE OR ADMINISTRATIVE POSITIONS NOT COVERED UNDER THIS POLICY, I.E., ALL POSITIONS BELOW VICE PRESIDENT. THE EXECUTIVE COMPENSATION POLICY WILL BE ANNUALLY REVIEWED AND ANY PROPOSED MODIFICATIONS, PRESENTED FOR APPROVAL TO THE FULL BOARD. IN SETTING AN EXAMPLE FOR ITS MEMBER ORGANIZATIONS, THE EXECUTIVE COMPENSATION COMMITTEE WILL ALSO UNDERTAKE THE RESPONSIBILITY FOR COMPLIANCE WITH THE 1996 TAXPAYER BILLS OF RIGHTS 2 AND THE ESTABLISHMENT OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" THAT IS DEFINED IN SECTION 4958 OF THE INTERNAL REVENUE CODE. IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THE EXECUTIVE COMPENSATION COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. FOR EXTERNAL COMPARISON PURPOSES, COMPENSATION IS REVIEWED AGAINST THE COMPENSATION PACKAGES OF OTHER STATE ASSOCIATIONS THAT FAIRLY REPRESENT THE MARKET FOR EXECUTIVE TALENT, AND MAY INCLUDE SOME OR ALL OF THE FOLLOWING CHARACTERISTICS: -- SIMILAR INDUSTRY AND/OR ANNUAL REVENUES SIZE -- SIMILAR STATE SIZE (POPULATION) AND MEMBERSHIP SIZE -- EMPLOYERS THAT ARE PRIMARILY FOCUSED ON THE SOUTHEAST REGION OF THE UNITED STATES -- ORGANIZATIONS WITH WHICH WE COMPETE FOR TALENT INDIVIDUAL SALARIES WILL BE BASED UPON SUCH FACTORS AS COMPETENCIES, CREDENTIALS, EXPERIENCE, PERFORMANCE, RELEVANT PRIOR EARNINGS HISTORY, AND MARKETABILITY. ANNUAL SALARY INCREASES WILL REFLECT SUCH FACTORS AS MARKET MOVEMENT OR INFLATION, INDIVIDUAL PERFORMANCE, COMPANY PERFORMANCE, GENERAL ECONOMIC CONDITIONS, AND THE AVAILABILITY OF FUNDS. IF A SALARY EXCEEDS THE RANGE MAXIMUM OR 75TH PERCENTILE, THE EXECUTIVE COMPENSATION COMMITTEE MUST APPROVE AND DOCUMENT ITS RATIONALE. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION PROVIDES COPIES UPON REQUEST AND ALLOWS INSPECTION AT THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION PROVIDES COPIES UPON REQUEST AND ALLOWS INSPECTION AT THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION. |
| FORM 990, PART XI, LINE 9: | CUMULATIVE EFFECT OF A CHANGE IN ACCOUNTING PRINCIPLE -472,612. |
| PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NCHA INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4449 | AddressLine1Txt |
| City | CARY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27519 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560641290 | EIN |
| Primary Activities | PROVIDES LEADERSHIP TO HOSPITALS IN NC & PROMOTES QUALITY HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(6) | ExemptCodeSectionTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA HEALTHCARE ENTERPRISES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4449 | AddressLine1Txt |
| City | CARY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27519 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561653026 | EIN |
| Primary Activities | SUPPORT SERVICES RELATED TO FOR-PROFIT ACTIVITIES. | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |