NORTH COUNTRY HEALTHCARE INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- NORTH COUNTRY HEALTHCARE INC (EIN 86-0663432)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-02
- IRS object ID
- 201931229349301583
- Schema version
- 2017v2.3
- 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 J
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-02T16:14:00-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 821455657 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FESTER & CHAPMAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9019 E BAHIA DR STE 100 | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85260 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860663432 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH COUNTRY HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 9285229400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2920 N 4TH ST | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 860041816 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANNE NEWLAND | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9285229400 | PhoneNum |
| Signature | 2019-05-01 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RACHEL R LOCKE CPA | PreparerPersonNm |
| PTIN | P00450405 | PTIN |
| Phone | 6022643077 | PhoneNum |
| Preparation | 2019-05-01 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 52.37.240.203 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-01 | IPDt |
| IP Tm | 12:03:35 | IPTm |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DF0EA5206D48450F037FD57DFE906C118EC0AE80 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A7D14FB925E4A23D42CFCABCFD39DFF9B6966A90 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANNE NEWLAND | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2920 N 4TH STREET | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $50,466,994 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHCOUNTRYHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESSIBLE, AFFORDABLE, COMPREHENSIVE, QUALITY PRIMARY HEALTHCARE IN AN ATMOSPHERE OF RESPECT, DIGNITY, AND CULTURAL SENSITIVITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 610 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $14,555,777 | PYContributionsGrantsAmt |
| CY Contributions Grants | $14,443,694 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,168,434 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,053,270 | CYProgramServiceRevenueAmt |
| PY Investment Income | $77,545 | PYInvestmentIncomeAmt |
| CY Investment Income | $124,616 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,395,765 | PYOtherRevenueAmt |
| CY Other Revenue | $4,755,642 | CYOtherRevenueAmt |
| PY Total Revenue | $43,197,521 | PYTotalRevenueAmt |
| CY Total Revenue | $46,377,222 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,133,070 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,454,163 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $87,546 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $191,902 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,790,041 | PYOtherExpensesAmt |
| CY Other Expenses | $14,690,504 | CYOtherExpensesAmt |
| PY Total Expenses | $42,923,111 | PYTotalExpensesAmt |
| CY Total Expenses | $46,232,213 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $274,410 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $145,009 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,070,925 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,900,170 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,720,478 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,400,133 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,350,447 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,500,037 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE ACCESSIBLE, AFFORDABLE, COMPREHENSIVE, QUALITY PRIMARY HEALTHCARE IN AN ATMOSPHERE OF RESPECT, DIGNITY, AND CULTURAL SENSITIVITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $33,582,289 | ExpenseAmt |
| Revenue | $27,053,270 | RevenueAmt |
| Desc | HEALTH CARE WAS PROVIDED TO MEDICALLY UNDERSERVED IN HEALTH PROFESSIONAL SHORTAGE AREAS. PROVIDE TRAINING AND CONTINUING EDUCATION TO HEALTH CARE PROFESSIONALS. | Desc |
| Total Program Service Expenses | $33,582,289 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 260 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 610 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AZ | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH COUNTRY HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9285229400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2920 N 4TH STREET | AddressLine1Txt |
| City | FLAGSTAFF | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 86004 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| PATRICIA CROFFORD BEGIN 62017 | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $1,788 | $0 | ||
| MARY JO GREGORY | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHERYL BLUME | |||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PAUL FERRIS | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SARAH BENATAR | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| AARON SECAKUKU | |||||||
| PRESIDENT EL | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHRIS FETZER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE GLEN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TOM SALERNO THROUGH 92018 | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MONICA BAKER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT POCHE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID CHAVEZ | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANNE NEWLAND | |||||||
| CEO | 40.00 | $217,238 | $0 | $9,010 | Yes (X) | ||
| CYNTHIA MARTIN | |||||||
| CMO | 40.00 | $207,846 | $0 | $6,632 | Yes (X) | ||
| GREG KUZMA | |||||||
| CFO | 40.00 | $156,316 | $0 | $3,131 | Yes (X) | ||
| MARTI NEFF | |||||||
| COO | 40.00 | $112,849 | $0 | $4,946 | Yes (X) | ||
| ANDREA KELLAR BLAZIC | |||||||
| PHYSICIAN OB | 40.00 | $277,579 | $0 | $0 | Yes (X) | ||
| BEVERLY TEW | |||||||
| PHYSICIAN OB | 40.00 | $242,322 | $0 | $0 | Yes (X) | ||
| ELIZABETH CLAXTON | |||||||
| PHYSICIAN OB | 40.00 | $232,771 | $0 | $0 | Yes (X) | ||
| KATHRYN FICK | |||||||
| PHYSICIAN OB | 40.00 | $213,015 | $0 | $0 | Yes (X) | ||
| NIZAR OLABI | |||||||
| PHYSICIAN OB | 40.00 | $206,154 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,866,090 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,788 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $23,719 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPHEALTH | |||||
| 6440 SOUTH MILLROCK DRIVE STE 175 | SALT LAKE CITY | UT | 84121 | LOCUM PROVIDER | $1,438,743 |
| ALLIANCE OF CHICAGO | |||||
| 215 W OHIO STREET | CHICAGO | IL | 60654 | EHR SUPPORT | $980,837 |
| BARTON ASSOCIATES INC | |||||
| 1050 WEST WASHINGTON ST | TEMPE | AZ | 85281 | LOCUM PROVIDER | $936,509 |
| FRONTIER COMMUNICATIONS | |||||
| PO BOX 5156 | TAMPA | FL | 33675 | PHONE & INTERNE | $852,832 |
| ACC BUSINESS | |||||
| 1300 W WASHINGTON STREET | PHOENIX | AZ | 85007 | PHONE/NET SRVC | $289,906 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising | $75,481 | FundraisingAmt |
| Government Grants | $11,878,649 | GovernmentGrantsAmt |
| All Other Contributions | $2,489,564 | AllOtherContributionsAmt |
| Noncash Contributions | $667,649 | NoncashContributionsAmt |
| Total Contributions | $14,443,694 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $27,053,270 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,053,270 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,053,270 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $114,631 | TotalRevenueColumnAmt |
| Exclusion | $114,631 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $121,315 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $111,330 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,985 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,985 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,985 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $75,481 | ContriRptFundraisingEventAmt |
| Gross Sales Of Inventory | $8,529,677 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $3,978,442 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,551,235 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,551,235 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $204,407 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $204,407 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $204,407 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,377,222 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,818,897 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $114,631 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $717,967 | TotalAmt |
| Program Services | $610,273 | ProgramServicesAmt |
| Management And General | $107,694 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,863,491 | TotalAmt |
| Program Services | $21,921,101 | ProgramServicesAmt |
| Management And General | $3,942,390 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,990 | TotalAmt |
| Program Services | $463,051 | ProgramServicesAmt |
| Management And General | $137,939 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,424,712 | TotalAmt |
| Program Services | $1,991,180 | ProgramServicesAmt |
| Management And General | $433,532 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,847,003 | TotalAmt |
| Program Services | $1,509,400 | ProgramServicesAmt |
| Management And General | $337,603 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,518 | TotalAmt |
| Management And General | $51,518 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,546 | TotalAmt |
| Fundraising | $87,546 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,360,813 | TotalAmt |
| Program Services | $3,521,501 | ProgramServicesAmt |
| Management And General | $839,031 | ManagementAndGeneralAmt |
| Fundraising | $281 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,516 | TotalAmt |
| Program Services | $200,169 | ProgramServicesAmt |
| Management And General | $309,853 | ManagementAndGeneralAmt |
| Fundraising | $25,494 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,399,948 | TotalAmt |
| Program Services | $8,219 | ProgramServicesAmt |
| Management And General | $1,391,729 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,521,547 | TotalAmt |
| Program Services | $55,841 | ProgramServicesAmt |
| Management And General | $1,465,706 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $886,115 | TotalAmt |
| Program Services | $600,171 | ProgramServicesAmt |
| Management And General | $284,262 | ManagementAndGeneralAmt |
| Fundraising | $1,682 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,502 | TotalAmt |
| Management And General | $204,502 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,049,505 | TotalAmt |
| Management And General | $1,049,505 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $1,147,217 | $862,921 | $241,607 | $42,689 |
| TELEPHONE | $917,122 | $86,764 | $830,358 | |
| REPAIRS AND MAINTENANCE | $897,335 | $294,273 | $603,062 | |
| IN-KIND IMMUNIZATIONS | $667,649 | $667,649 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,051,717 | TotalAmt |
| Program Services | $789,776 | ProgramServicesAmt |
| Management And General | $227,731 | ManagementAndGeneralAmt |
| Fundraising | $34,210 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,232,213 | TotalAmt |
| Program Services | $33,582,289 | ProgramServicesAmt |
| Management And General | $12,458,022 | ManagementAndGeneralAmt |
| Fundraising | $191,902 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,752,701 | BOYAmt |
| EOY | $1,228,345 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,278 | BOYAmt |
| EOY | $119,757 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,008,950 | BOYAmt |
| EOY | $985,109 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,734,615 | BOYAmt |
| EOY | $6,458,448 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,004 | BOYAmt |
| EOY | $484,443 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $296,248 | BOYAmt |
| EOY | $307,660 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,423,667 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,759,511 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,277,453 | BOYAmt |
| EOY | $16,664,156 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,482,676 | BOYAmt |
| EOY | $2,652,252 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,070,925 | BOYAmt |
| EOY | $28,900,170 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,271,318 | BOYAmt |
| EOY | $3,433,330 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,527,572 | BOYAmt |
| EOY | $5,288,366 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $921,588 | BOYAmt |
| EOY | $678,437 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,720,478 | BOYAmt |
| EOY | $9,400,133 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,945,885 | BOYAmt |
| EOY | $19,067,533 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,278 | BOYAmt |
| EOY | $119,757 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,284 | BOYAmt |
| EOY | $312,747 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,350,447 | BOYAmt |
| EOY | $19,500,037 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,070,925 | BOYAmt |
| EOY | $28,900,170 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $145,009 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,581 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $19,144,720 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,297,868 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,678,742 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,696,609 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,443,694 | CurrentTaxYearAmt |
| Total | $75,261,633 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,144,720 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,297,868 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,678,742 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,696,609 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,443,694 | CurrentTaxYearAmt |
| Total | $75,261,633 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $75,261,633 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $64,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $118,584 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $57,874 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $74,516 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $114,631 | CurrentTaxYearAmt |
| Total | $430,136 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $6,242 | CurrentTaxYearMinus3YearsAmt |
| Total | $6,242 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $713,249 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $917,768 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $649,483 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $485,077 | CurrentTaxYearMinus1YearAmt |
| Total | $2,765,577 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $78,463,588 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $35,787,354 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95920 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95460 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | OTHER-TOTAL FOR 5 YEARS 2,765,577 | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $404,562 | BeginningYearBalanceAmt |
| Contributions | $140,879 | ContributionsAmt |
| Investment Earnings Or Losses | $14,383 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$127,320 | OtherExpendituresAmt |
| End Year Balance | $432,504 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $547,447 | BeginningYearBalanceAmt |
| Contributions | $123,470 | ContributionsAmt |
| Investment Earnings Or Losses | $8,854 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$275,209 | OtherExpendituresAmt |
| End Year Balance | $404,562 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $348,234 | BeginningYearBalanceAmt |
| Contributions | $170,488 | ContributionsAmt |
| Investment Earnings Or Losses | $28,725 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $547,447 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $303,425 | BeginningYearBalanceAmt |
| Contributions | $27,985 | ContributionsAmt |
| Investment Earnings Or Losses | $16,824 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $348,234 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.72000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.28000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,061,430 | OtherCostOrOtherBasisAmt |
| Book Value | $2,061,430 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,013,914 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,967,971 | DepreciationAmt |
| Book Value | $13,045,943 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,348,323 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,791,540 | DepreciationAmt |
| Book Value | $1,556,783 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,664,156 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDABLE GRANT ADVANCES | Desc |
| Amt | $678,437 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $678,437 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $50,454,598 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,581 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $94,353 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $3,978,442 | OtherRevenueAmt |
| Revenue Not Reported | $4,077,376 | RevenueNotReportedAmt |
| Revenue Subtotal | $46,377,222 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $46,377,222 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $50,305,008 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $94,353 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $3,978,442 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $4,072,795 | ExpensesNotReportedAmt |
| Expenses Subtotal | $46,232,213 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $46,232,213 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | TO PAY FOR OUTSIDE MEDICAL EXPENSES OF PATIENTS WHO CANNOT AFFORD PAYMENT THEMSELVES. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | COST OF GOODS SOLD 3,978,442 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | COST OF GOODS SOLD 3,978,442 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | OTHER FUNDRAISI | Event1Nm |
| Gross Receipts Event1 | $75,481 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $75,481 | CharitableContriEvent1Amt |
| Gross Receipts Total | $75,481 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $75,481 | CharitableContributionsTotAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| ANNE NEWLAND | ||||
| CEO | $204,286 | $12,952 | $9,010 | $226,248 |
| CYNTHIA MARTIN | ||||
| CMO | $186,747 | $21,099 | $6,632 | $214,478 |
| GREG KUZMA | ||||
| CFO | $156,316 | $3,131 | $159,447 | |
| ANDREA KELLAR BLAZIC | ||||
| PHYSICIAN OB-GYN | $251,914 | $25,665 | $277,579 | |
| BEVERLY TEW | ||||
| PHYSICIAN OB-GYN | $217,777 | $24,545 | $242,322 | |
| ELIZABETH CLAXTON | ||||
| PHYSICIAN OB-GYN | $208,225 | $24,546 | $232,771 | |
| KATHRYN FICK | ||||
| PHYSICIAN OB-GYN | $204,277 | $8,738 | $213,015 | |
| NIZAR OLABI | ||||
| PHYSICIAN OB-GYN | $194,940 | $11,214 | $206,154 | |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| WILLIAMS HOSPITAL DISTRICT | |||
| HCIC DIRECTOR | $557,913 | OPERATING SUBSIDY | false |
| WILLIAMS HOSPITAL DISTRICT | |||
| HCIC DIRECTOR | $475,000 | CORPORATE ALLOCATION | false |
| PATRICIA CROFFORD | |||
| DIRECTOR | $1,788 | HR CONSULTING | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | GEORGE GLEN IS THE BOARD DIRECTOR OF BOTH NCHC AND WILLIAMS HOSPITAL DISTRICT. PER AN MANAGEMENT AND OPERATING AGREEMENT SIGNED IN 2011, AND EFFECTIVE FROM JANUARY 2011 THROUGH JANUARY 2021, NCHC OCCUPIES THE BUILDING THAT IS OWNED BY THE DISTRICT IN WILLIAMS, ARIZONA. NCHC OPERATES IN THE BUILDING, AND RECEIVES OPERATING SUBSIDY AND OPERATING EXPENSE REIMBURSEMENT FROM THE DISTRICT. PRIOR TO JOINING THE BOARD IN JUNE 2017, MS. PATRICIA CROFFORD PERFORMED HR CONSULTING SERVICES FOR THE CORPORATION IN FY17 WHERE SHE RECEIVED 1,788 FOR THOSE SERVICES. MARY JO GREGORY IS THE PRESIDENT AND CEO OF THE NARBHA INSTITUTE, INC. NARBHA INSTITUTE IN TURN, OWNS 48% (WITH 50% GOVERNANCE) OF HEALTH CHOICE INTEGRATED CARE, LLC ("HCIC"), A JOINT VENTURE OF THE NARBHA INSTITUTE AND STEWARD HEALTH CHOICE. HCIC HOLDS A DELEGATED GOVERNANCE AGREEMENT WITH STEWARD HEALTH CHOICE ARIZONA OVERSEEING ONE OF THE TWO MANAGED CARE CONTRACTS BETWEEN STEWARD HEALTH CHOICE ARIZONA AND THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ("AHCCCS"), THE STATE MEDICAID AGENCY IN ARIZONA. FROM 10/1/2015 UNTIL 10/1/2018, HCIC HELD THIS CONTRACT DIRECTLY. THE CORPORATION RECEIVES APPROXIMATELY 0.5 MILLION OF ITS REVENUE FROM STEWARD HEALTH CHOICE (OR FROM HCIC FOR DATES OF SERVICE PRIOR TO 10/1/18). IN SEPTEMBER 2017, STEWARD HEALTH CARE SYSTEM, LLC ACQUIRED IASIS HEALTHCARE, LLC, INCLUDING IASIS' INTEREST IN HCIC AND IASIS' SUBSIDIARIES INCLUDING HEALTH CHOICE ARIZONA (NOW STEWARD HEALTH CHOICE ARIZONA). IN AUGUST, 2018, NARBHA INSTITUTE BECAME THE SOLE CORPORATE MEMBER OF ANOTHER 501(C)(3) PUBLIC CHARITY, THE GUIDANCE CENTER INC. ("TGC") WHERE THE CORPORATION HAS AN INTEGRATION CLINIC IN FLAGSTAFF. IN DECEMBER 2017, NARBHA INSTITUTE AGREED, IN PRINCIPAL, TO FUND UP TO 3 MILLION OVER A FIVE YEAR PERIOD, FOR A GRADUATE MEDICAL RESIDENCY PROGRAM FOR THE CORPORATION. IN FY 2018, NO FUNDS WERE REQUESTED OR RECEIVED RELATED TO THIS COMMITMENT. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $667,649 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 | BEGINNING NET ASSETS CHANGED FROM PRIOR YEAR'S 990 ENDING NET ASSETS DUE TO FOUNDATION FINANCIALS ARE CONSOLIDATED IN CURRENT YEAR. |
| FORM 990, PAGE 5, PART V, LINE 3B | RENTAL INCOME ENDED IN FY 18. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WILL BE PROVIDED AND REVIEWED BY THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ISSUES THAT ARE FLAGGED AS POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO THE ATTENTION OF THE SENIOR MANAGEMENT TEAM MEMBERS (CEO, CFO, CMO) AND THE HR DIRECTOR. A DECISION IS THEN REACHED REGARDING HOW THESE CONFLICTS SHOULD BE HANDLED. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION SURVEY'S ARE REVIEWED ALONG WITH LOCAL MARKET CONDITIONS IN ORDER TO DETERMINE WHAT COMPENSATION AMOUNTS ARE CONSIDERED REASONABLE. ALSO FACTORED INTO CONSIDERATION IS THE EXPERIENCE, JOB PERFORMANCE AND QUALIFICATIONS OF THESE STAFF. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION SURVEYS ARE REVIEWED ALONG WITH LOCAL MARKET CONDITIONS IN ORDER TO DETERMINE WHAT COMPENSATION AMOUNTS ARE CONSIDERED REASONABLE. ALSO FACTORED INTO CONSIDERATION IS THE EXPERIENCE, JOB PERFORMANCE AND QUALIFICATIONS OF THESE STAFF. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | COST OF GOODS SOLD 3,978,442 COST OF GOODS SOLD -3,978,442 |