Indian Stream Health Center Inc: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- Indian Stream Health Center Inc (EIN 20-0999212)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-10-31
- IRS object ID
- 201943049349300509
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-10-31T07:57:11-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 221478099 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COHNREZNICK LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 CHURCH STREET 12TH FLOOR | AddressLine1Txt |
| City | HARTFORD | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200999212 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIAN STREAM HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 6032378336 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 CORLISS LANE | AddressLine1Txt |
| City | COLEBROOK | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03756 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN J KELLEY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6032378336 | PhoneNum |
| Signature | 2019-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL BALLASY | PreparerPersonNm |
| PTIN | P00852868 | PTIN |
| Phone | 9592007000 | PhoneNum |
| Preparation | 2019-10-27 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 209.59.242.22 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-10-28 | IPDt |
| IP Tm | 09:21:41 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 238159564A7F207AC3E2D33505B4833284B8AC6F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN J KELLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 CORLISS LANE | AddressLine1Txt |
| City | COLEBROOK | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03756 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,156,647 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.INDIANSTREAM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE EXCELLENT PREVENTIVE, ACUTE, AND WELLNESS-FOCUSED HEALTH CARE TO RESIDENTS WITHIN THE ORGANIZATION'S SERVICE AREA REGARDLESS OF PATIENT'S ABILITY TO PAY. WE WILL FOCUS OUR RESOURCES TO MAXIMIZE THE QUALITY OF LIFE OF AREA RESIDENTS IN A COST-EFFECTIVE AND EFFICIENT MANNER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 81 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $126,175 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,266,573 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,030,828 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,386,429 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,038,995 | CYProgramServiceRevenueAmt |
| PY Investment Income | $75 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $71,870 | PYOtherRevenueAmt |
| CY Other Revenue | $86,824 | CYOtherRevenueAmt |
| PY Total Revenue | $6,724,947 | PYTotalRevenueAmt |
| CY Total Revenue | $6,156,647 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,861,137 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,135,384 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,182,589 | PYOtherExpensesAmt |
| CY Other Expenses | $2,303,513 | CYOtherExpensesAmt |
| PY Total Expenses | $8,043,726 | PYTotalExpensesAmt |
| CY Total Expenses | $6,438,897 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,318,779 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$282,250 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,976,804 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,773,867 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $863,202 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $942,515 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,113,602 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,831,352 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE EXCELLENT PREVENTIVE, ACUTE, AND WELLNESS-FOCUSED HEALTH CARE TO RESIDENTS WITHIN THE ORGANIZATION'S SERVICE AREA REGARDLESS OF PATIENT'S ABILITY TO PAY. WE WILL FOCUS OUR RESOURCES TO MAXIMIZE THE QUALITY OF LIFE OF AREA RESIDENTS IN A COST-EFFECTIVE AND EFFICIENT MANNER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,398,345 | ExpenseAmt |
| Revenue | $3,998,664 | RevenueAmt |
| Desc | PROVIDE PRIMARY HEALTH CARE TO THE RESIDENTS OF THE COLEBROOK, NH REGION. | Desc |
| Total Program Service Expenses | $4,398,345 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 81 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | 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 | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHILIP KNEER | PersonNm |
| Phone | 6032378336 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 CORLISS LANE | AddressLine1Txt |
| City | COLEBROOK | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03756 | 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 |
|---|---|---|---|---|---|---|---|
| CASSIE HURLBERT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DALLAS CHASE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID THATCHER | |||||||
| TREASURER | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GAIL FISHER | |||||||
| PAST PRESIDENT | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GREG CULLEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER NOYES | |||||||
| PRESIDENT | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| LINDA LOMASNEY | |||||||
| OUTGOING BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDSAY RANCOURT | |||||||
| OUTGOING BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LORI MORANN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE BRUTNICK | |||||||
| SECRETARY | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SCOTT COOPER | |||||||
| OUTGOING BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE ELLIS | |||||||
| VICE PRESIDENT | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUZANNE PHINNEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GRAHAM RAE | |||||||
| CFO THRU 3/18 | 40.00 | $33,431 | $0 | $1,254 | Yes (X) | ||
| KEVIN J KELLEY | |||||||
| CEO | 40.00 | $93,945 | $0 | $3,928 | Yes (X) | ||
| PHILIP G KNEER JR | |||||||
| FINANCE DIRECTOR | 40.00 | $77,391 | $0 | $20,815 | Yes (X) | ||
| ELIZABETH SWEENEY | |||||||
| DO | 40.00 | $132,141 | $0 | $23,897 | Yes (X) | ||
| MARGARET R FITZGERALD | |||||||
| MEDICAL DIRECTOR | 40.00 | $126,300 | $0 | $4,046 | Yes (X) | ||
| MARY JUDD | |||||||
| PA | 40.00 | $105,894 | $0 | $17,568 | Yes (X) | ||
| PAULA TROIE | |||||||
| PHARMACIST | 40.00 | $119,951 | $0 | $24,438 | Yes (X) | ||
| PETER MORAN | |||||||
| MD | 40.00 | $207,699 | $0 | $21,088 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $896,752 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $117,034 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SHEEHAN PHINNEY BASS & GREEN | |||||
| PO BOX 3701 | MANCHESTER | NH | 06105 | LEGAL SERVICES | $220,740 |
| BARTON ASSOCIATES | |||||
| PO BOX 417844 | BOSTON | MA | 02241 | LOCUM MD SERVICES | $109,990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,028,678 | GovernmentGrantsAmt |
| All Other Contributions | $2,150 | AllOtherContributionsAmt |
| Noncash Contributions | $56,806 | NoncashContributionsAmt |
| Total Contributions | $2,030,828 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PHARMACY REVENUE | 621110 | $1,249,398 | $1,123,223 | $126,175 |
| MEDICARE | 621110 | $1,072,426 | $1,072,426 | |
| MEDICAID | 621110 | $685,293 | $685,293 | |
| THIRD PARTY PAYORS | 621110 | $567,827 | $567,827 | |
| NURSING SERVICES | 621110 | $347,790 | $347,790 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $116,261 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $116,261 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,038,995 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $980 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $980 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $980 | TotalRevenueColumnAmt |
| Exclusion | $980 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INCENTIVE PAYMENTS | 900099 | $57,681 | $57,681 |
| MISCELLANEOUS REVENUE | 900099 | $28,163 | $28,163 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $85,844 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,156,647 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,998,664 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $126,175 | UnrelatedBusinessRevenueAmt |
| Exclusion | $980 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,764 | TotalAmt |
| Program Services | $161,816 | ProgramServicesAmt |
| Management And General | $68,948 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,070,663 | TotalAmt |
| Program Services | $2,153,208 | ProgramServicesAmt |
| Management And General | $917,455 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,756 | TotalAmt |
| Program Services | $44,006 | ProgramServicesAmt |
| Management And General | $18,750 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,626 | TotalAmt |
| Program Services | $370,683 | ProgramServicesAmt |
| Management And General | $157,943 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,575 | TotalAmt |
| Program Services | $170,098 | ProgramServicesAmt |
| Management And General | $72,477 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,810 | TotalAmt |
| Management And General | $105,810 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,431 | TotalAmt |
| Management And General | $60,431 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564,627 | TotalAmt |
| Program Services | $243,010 | ProgramServicesAmt |
| Management And General | $321,617 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,979 | TotalAmt |
| Program Services | $132,269 | ProgramServicesAmt |
| Management And General | $77,710 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,045 | TotalAmt |
| Program Services | $142,659 | ProgramServicesAmt |
| Management And General | $58,386 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,007 | TotalAmt |
| Program Services | $6,690 | ProgramServicesAmt |
| Management And General | $5,317 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,948 | TotalAmt |
| Management And General | $11,948 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,544 | TotalAmt |
| Program Services | $104,695 | ProgramServicesAmt |
| Management And General | $42,849 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,628 | TotalAmt |
| Program Services | $38,763 | ProgramServicesAmt |
| Management And General | $15,865 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PHARMACY COSTS | $587,300 | $587,300 |
| BAD DEBTS | $127,717 | $127,717 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,477 | TotalAmt |
| Program Services | $115,431 | ProgramServicesAmt |
| Management And General | $105,046 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,438,897 | TotalAmt |
| Program Services | $4,398,345 | ProgramServicesAmt |
| Management And General | $2,040,552 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,482 | BOYAmt |
| EOY | $179,287 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,639 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,024 | BOYAmt |
| EOY | $13,119 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $386,931 | BOYAmt |
| EOY | $362,034 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,978 | BOYAmt |
| EOY | $88,538 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,471 | BOYAmt |
| EOY | $68,496 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,837,465 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $775,072 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,235,279 | BOYAmt |
| EOY | $2,062,393 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,976,804 | BOYAmt |
| EOY | $2,773,867 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $583,177 | BOYAmt |
| EOY | $665,743 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,420 | BOYAmt |
| EOY | $42,716 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,605 | BOYAmt |
| EOY | $234,056 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,202 | BOYAmt |
| EOY | $942,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,113,602 | BOYAmt |
| EOY | $1,831,352 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,113,602 | BOYAmt |
| EOY | $1,831,352 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,976,804 | BOYAmt |
| EOY | $2,773,867 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$282,250 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $1,548,429 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,704,540 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,108,170 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,266,573 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,030,828 | CurrentTaxYearAmt |
| Total | $9,658,540 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,035,362 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,917,246 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,408,316 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,386,429 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,912,820 | CurrentTaxYearAmt |
| Total | $19,660,173 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,583,791 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,621,786 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,516,486 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,653,002 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,943,648 | CurrentTaxYearAmt |
| Total | $29,318,713 | 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 | $29,318,713 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $26,502 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,706 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $980 | CurrentTaxYearAmt |
| Total | $29,188 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $26,502 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,706 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $980 | CurrentTaxYearAmt |
| Total | $29,188 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $126,175 | CurrentTaxYearAmt |
| Total | $126,175 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $47,527 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $71,870 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $85,844 | CurrentTaxYearAmt |
| Total | $205,241 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,583,791 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,621,786 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,590,515 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,726,578 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,156,647 | CurrentTaxYearAmt |
| Total | $29,679,317 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98780 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99470 | PublicSupportPY509Pct |
| Investment Income CY | 0.00100 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00100 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | INCENTIVE PAYMENTS - 2016 AMOUNT: $ 47,527. 2017 AMOUNT: $ 37,180. 2018 AMOUNT: $ 57,681. MISCELLANEOUS REVENUE - 2017 AMOUNT: $ 34,690. 2018 AMOUNT: $ 28,163. | ExplanationTxt |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,000 | OtherCostOrOtherBasisAmt |
| Book Value | $60,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,398,908 | OtherCostOrOtherBasisAmt |
| Depreciation | $577,344 | DepreciationAmt |
| Book Value | $1,821,564 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $378,557 | OtherCostOrOtherBasisAmt |
| Depreciation | $197,728 | DepreciationAmt |
| Book Value | $180,829 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,062,393 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,028,930 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$127,717 | OtherRevenueAmt |
| Revenue Not Reported | -$127,717 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,156,647 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,156,647 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,311,180 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,311,180 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $127,717 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $127,717 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,438,897 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2018 AND 2017. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2015 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE CENTER RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS, AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE STATEMENTS OF FINANCIAL POSITION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS -127,717. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 127,717. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH SWEENEY | ||||||||||||||
| DO | $122,042 | $0 | $10,000 | $0 | $99 | $0 | $3,978 | $0 | $19,919 | $0 | $156,038 | $0 | $0 | $0 |
| PETER MORAN | ||||||||||||||
| MD | $206,465 | $0 | $0 | $0 | $1,234 | $0 | $6,082 | $0 | $15,006 | $0 | $228,787 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | CERTAIN HIGHLY COMPENSATED EMPLOYEES RECEIVED BOARD APPROVED BONUSES WHICH ARE REPORTED IN THEIR 2018 W2. | 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 | $56,806 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | INDIAN STREAM HEALTH CENTER INC REQUIRES THEIR BOARD MEMBERS TO ANNUALLY SIGN A FORM STATING WHAT OTHER ORGANIZATIONS THEY ARE INVOLVED IN. THE BOARD MEMBERS ARE NOT ALLOWED TO VOTE ON ISSUES IF THEY PERTAIN TO ANOTHER ORGANIZATION THE BOARD MEMBER IS INVOLVED WITH. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS OF INDIAN STREAM HEALTH CENTER, INC CHECKED SALARY INFORMATION FROM OTHER FQHCS AND REVIEWED THE FORM 990S OF THE OTHER NON-PROFITS TO OBTAIN COMPARBILITY INFORMATION FOR THE OFFICERS' SALARIES.- THE ORGANIZATION ALSO PARTICIPATED IN NACHCS SALARY SURVEY. |
| FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990 PART XII, LINE 2C | THERE HAVE BEEN NO CHANGES MADE TO THE ORGANIZATION'S OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. |