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BUCKSPORT REGIONAL HEALTH CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
BUCKSPORT REGIONAL HEALTH CENTER (EIN 23-7335894)
Tax period
2018-04-01 to 2019-03-31
Filed
2019-08-15
IRS object ID
201932279349300733
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2019-08-15T08:07:02-05:00ReturnTs
Tax Period End2019-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010411241PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CHESTER M KEARNEY PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1550AddressLine1Txt
CityPRESQUE ISLECityNm
State AbbreviationMEStateAbbreviationCd
ZIP04769ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237335894EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BUCKSPORT REGIONAL HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBUCKBusinessNameControlTxt
Phone2074692366PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 BROADWAYAddressLine1Txt
CityBUCKSPORTCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04416ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCAROL M CAREWPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone2074692366PhoneNum
Signature2019-08-12SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTIMOTHY P POITRASPreparerPersonNm
PTINP00542788PTIN
Phone2077643171PhoneNum
Preparation2019-08-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address64.89.241.30IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-08-15IPDt
IP Tm08:07:02IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA5BAE26B8730DD96AB5224EC72C46CD2F0EAC8A7AtSubmissionCreationDeviceId
At Submission Filing Device IdA5BAE26B8730DD96AB5224EC72C46CD2F0EAC8A7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANN REMICKPrincipalOfficerNm
Gross Receipts$7,777,722GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BUCKSPORTRHC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionBUCKSPORT REGIONAL HEALTH CENTER'S MISSION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH AND COMMUNITY SERVICES IN THE BUCKSPORT, MAINE AREA. IT IS A FEDERALLY QUALIFIED HEALTH CENER.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee93TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$2,355,208PYContributionsGrantsAmt
CY Contributions Grants$2,163,816CYContributionsGrantsAmt
PY Program Service Revenue$4,789,007PYProgramServiceRevenueAmt
CY Program Service Revenue$5,422,791CYProgramServiceRevenueAmt
PY Investment Income$16,801PYInvestmentIncomeAmt
CY Investment Income$17,686CYInvestmentIncomeAmt
PY Other Revenue$36,016PYOtherRevenueAmt
CY Other Revenue$173,429CYOtherRevenueAmt
PY Total Revenue$7,197,032PYTotalRevenueAmt
CY Total Revenue$7,777,722CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,634,399PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,127,986CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,352,872PYOtherExpensesAmt
CY Other Expenses$2,777,103CYOtherExpensesAmt
PY Total Expenses$6,987,271PYTotalExpensesAmt
CY Total Expenses$7,905,089CYTotalExpensesAmt
PY Revenues Less Expenses$209,761PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$127,367CYRevenuesLessExpensesAmt
Total Assets BOY$6,808,510TotalAssetsBOYAmt
Total Assets EOY$6,537,959TotalAssetsEOYAmt
Total Liabilities BOY$2,653,092TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,509,968TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,155,418NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,027,991NetAssetsOrFundBalancesEOYAmt
MissionBUCKSPORT REGIONAL HEALTH CENTER'S MISSION IS TO PROVIDE MEDICAL, DENTAL AND OTHER HEALTH AND COMMUNITY SERVICES IN THE BUCKSPORT, MAINE AREA. IT IS A FEDERALLY QUALIFIED HEALTH CENER.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$6,617,150ExpenseAmt
Revenue$5,422,791RevenueAmt
DescTHE CENTER PROVIDES OUTPATIENT MEDICAL, BEHAVIORAL HEALTH AND DENTAL CARE SERVICES TO BUCKSPORT AND SURROUNDING AREA POPULATION.Desc
Total Program Service Expenses$6,617,150TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee93EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMEStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSUSAN ENGLANDPersonNm
Phone2074697371PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 BROADWAYAddressLine1Txt
CityBUCKSPORTCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04416ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANN REMICK
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
DONALD HOUGHTON
DIRECTOR1.00Yes (X)$0$0$0
MICHAEL ORMSBY
VICE PRESIDE1.00Yes (X)Yes (X)$0$0$0
GERALD COUTURE
TREASURER1.00Yes (X)Yes (X)$0$0$0
GARY MURRAY
DIRECTOR1.00Yes (X)$0$0$0
RICHARD SMITH
DIRECTOR1.00Yes (X)$0$0$0
VALERIE SULYA
DIRECTOR1.00Yes (X)$0$0$0
HEATHER BRAY
DIRECTOR1.00Yes (X)$0$0$0
LINDA VINON
DIRECTOR1.00Yes (X)$0$0$0
DAVID DOANE
DIRECTOR1.00Yes (X)$0$0$0
CAROL M CAREW
EXECUTIVE DI40.00Yes (X)$170,325$0$19,868
SUSAN ENGLAND
CHIEF FINANC40.00Yes (X)$91,953$0$8,764
JACKIE HUNT
DIRECTOR1.00Yes (X)$0$0$0
HANS L DUVELFELT
MD40.00$296,203$0$24,500Yes (X)
PAUL GUALTIERI
DENTIST40.00$166,631$0$3,269Yes (X)
TIMOTHY S CLIFFORD JR
MD40.00$149,632$0$0Yes (X)
CINDY AVERY
MD40.00$141,543$0$18,500Yes (X)
SHUBHRANGSU BISWAS
MD40.00$107,500$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,123,787TotalReportableCompFromOrgAmt
Total Other Compensation$74,901TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AROOSTOOK MENTAL HEALTH CENTER
PO BOX 1018CARIBOUME04736CONTRACT SERV.$193,643
LOCUM TENENSCOM
2575 NORTHWINDS PARKWAYALPHARETTAGA30009CONTRACT SERV.$179,439
E CLINICAL WORKS LLC
2 TECHNOLOGY DRIVEWESTBOROUGHMA01581CONTRACT SERV$148,464
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$2,130,316GovernmentGrantsAmt
All Other Contributions$33,500AllOtherContributionsAmt
Total Contributions$2,163,816TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Total Revenue Column$5,422,791TotalRevenueColumnAmt
Related Or Exempt Func Income$5,422,791RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$5,422,791TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,686TotalRevenueColumnAmt
Related Or Exempt Func Income$17,686RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Total Revenue Column$173,429TotalRevenueColumnAmt
Related Or Exempt Func Income$173,429RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$173,429OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,777,722TotalRevenueColumnAmt
Related Or Exempt Func Income$5,613,906RelatedOrExemptFuncIncomeAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,167,630TotalAmt
Program Services$3,274,048ProgramServicesAmt
Management And General$893,582ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$645,426TotalAmt
Program Services$488,742ProgramServicesAmt
Management And General$156,684ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$314,930TotalAmt
Program Services$238,091ProgramServicesAmt
Management And General$76,839ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$720,672TotalAmt
Program Services$656,605ProgramServicesAmt
Management And General$64,067ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$251,230TotalAmt
Program Services$239,615ProgramServicesAmt
Management And General$11,615ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,779TotalAmt
Program Services$1,039ProgramServicesAmt
Management And General$3,740ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$100,239TotalAmt
Program Services$72,459ProgramServicesAmt
Management And General$27,780ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$262,067TotalAmt
Program Services$261,950ProgramServicesAmt
Management And General$117ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$68,727TotalAmt
Program Services$55,332ProgramServicesAmt
Management And General$13,395ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$822,942$818,806$4,136
RECRUITING$291,787$291,787
DUES & PUBLICATIONS$80,298$75,706$4,592
RENT$78,235$69,122$9,113

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$96,127TotalAmt
Program Services$73,848ProgramServicesAmt
Management And General$22,279ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,905,089TotalAmt
Program Services$6,617,150ProgramServicesAmt
Management And General$1,287,939ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$381,155BOYAmt
EOY$77,849EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,330,209BOYAmt
EOY$1,339,818EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$610,664BOYAmt
EOY$765,260EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$38,199BOYAmt
EOY$69,929EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,848,915LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,841,481LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,170,554BOYAmt
EOY$4,007,434EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$277,729BOYAmt
EOY$277,669EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,808,510BOYAmt
EOY$6,537,959EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$312,337BOYAmt
EOY$356,603EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$75,913BOYAmt
EOY$19,714EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,264,842BOYAmt
EOY$2,133,651EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,653,092BOYAmt
EOY$2,509,968EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,817,435BOYAmt
EOY$3,674,214EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$337,983BOYAmt
EOY$353,777EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,155,418BOYAmt
EOY$4,027,991EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,808,510BOYAmt
EOY$6,537,959EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$127,367ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$60NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,717,317CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,044,498CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,197,240CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,355,208CurrentTaxYearMinus1YearAmt
Current Tax Year$2,163,816CurrentTaxYearAmt
Total$10,478,079TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,717,317CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,044,498CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,197,240CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,355,208CurrentTaxYearMinus1YearAmt
Current Tax Year$2,163,816CurrentTaxYearAmt
Total$10,478,079TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$10,478,079PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,825CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,490CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,808CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,801CurrentTaxYearMinus1YearAmt
Current Tax Year$17,686CurrentTaxYearAmt
Total$81,610TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,579CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,231CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,047CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$36,016CurrentTaxYearMinus1YearAmt
Current Tax Year$173,429CurrentTaxYearAmt
Total$226,302TotalAmt
FieldValueIRS element (for citing)
Total Support$10,785,991TotalSupportAmt
Gross Receipts Rltd Activities$10,457,095GrossReceiptsRltdActivitiesAmt
Public Support CY1700.97150PublicSupportCY170Pct
Public Support PY1700.98470PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 10FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME 226,302ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$269,825BeginningYearBalanceAmt
Investment Earnings Or Losses$20,693InvestmentEarningsOrLossesAmt
Other Expenditures$12,789OtherExpendituresAmt
End Year Balance$277,729EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$262,102BeginningYearBalanceAmt
Investment Earnings Or Losses$20,722InvestmentEarningsOrLossesAmt
Other Expenditures$12,999OtherExpendituresAmt
End Year Balance$269,825EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$277,697BeginningYearBalanceAmt
Investment Earnings Or Losses-$2,931InvestmentEarningsOrLossesAmt
Other Expenditures$12,664OtherExpendituresAmt
End Year Balance$262,102EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$282,529BeginningYearBalanceAmt
Investment Earnings Or Losses$10,152InvestmentEarningsOrLossesAmt
Other Expenditures$14,984OtherExpendituresAmt
End Year Balance$277,697EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$126,145OtherCostOrOtherBasisAmt
Book Value$126,145BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,722,770OtherCostOrOtherBasisAmt
Depreciation$3,841,481DepreciationAmt
Book Value$3,881,289BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,007,434TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$7,777,722TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$7,777,722RevenueSubtotalAmt
Total Revenue Per Form990$7,777,722TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$7,905,089TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$7,905,089ExpensesSubtotalAmt
Total Expenses Per Form990$7,905,089TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4FormAndLineReferenceDesc
ExplanationTO PURCHASE MEDICAL EQUIPMENT TO BE USED IN CONJUCTION WITH THE ORGANIZATION'S MISSION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
CAROL M CAREW
EXECUTIVE DIRECTOR$170,325$19,868$190,193
HANS L DUVELFELT
MD$296,203$24,500$320,703
PAUL GUALTIERI
DENTIST$166,631$3,269$169,900
CINDY AVERY
MD$141,543$18,500$160,043

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS REVIEWED AND APPROVED BY BOARD PRIOR TO SUBMISSION
FORM 990, PAGE 6, PART VI, LINE 12CPART VI, SECTION B - POLICIES ITEM 12C DOES THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WTH A CONFLICT OF INTEREST POLICY? THE BOARD OF DIRECTORS EACH HAS THEIR PERSONAL COPY OF THE BY-LAWS OF THE HEATLH CENTER WHICH SPECIFIES IN ARTICLE VI, SECTION 5 THAT "MEMBERS OF THE BOARD SHALL EXCLUDE THEMSELVES FROM VOTING ON ANY ISSUE, MOTION, OR RESOLUTION WHICH MAY DIRECTLY OR INDIRECTLY INURE TO THEIR BENFIT." CONFLICT OF INTEREST MAY BE RAISED BY ANY BOARD MEMBER AT ANY BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 15AITEMS 15A AND 15B-THE BOARD DETERMINES THE COMPENSATION FOR THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION FOR ALL OTHER EMPLOYEES INCLUDING KEY EMPLOYEES. THE DECISIONS USE THE MANAGMENT COMPENSATION SURVEY ISSUED ANNUALLY BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION FOR THE EXECUTIVE DIREDTOR'S COMPENSATION COMPARABILITY. THE KEY EMPLOYEES' COMPENSATION IS DETERMINED USING THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY ISSUED ANNUALLY BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION. THE BOARD ANNUALLY APPOINTS A COMMITTEE OF THE BOARD TO REVIEW AND EVALUATE THE EXECUTIVE DIRECTOR. THE COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD FOR ITS CONSIDERATION. THE BOARD DELEGATGES ALL PERSONNEL MATTERS TO THE EXECUTIVE DIRECTOR. ANNUAL REVIEWS ARE CONDUCTED. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED USING THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY.
FORM 990, PAGE 6, PART VI, LINE 15BITEMS 15A AND 15B-THE BOARD DELEGATES ALL PERSONNEL MATTERS TO THE EXECUTIVE DIRECTOR. ANNUAL REVIEWS ARE CONDUCTED. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED USING THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY. OFFICERS ARE NOT COMPENSATED.
FORM 990, PAGE 6, PART VI, LINE 19A COPY OF THE BY-LAWS AND RECENT AUDITED FINANCIAL STATEMENTS IS AVAILABLE ON REQUEST FOR PUBLIC REVIEW DURING REGULAR BUSINESS HOURS