CRUSADERS CENTRAL CLINIC ASSOCIATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CRUSADERS CENTRAL CLINIC ASSOCIATION (EIN 23-7076080)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-02-28
- IRS object ID
- 201710599349301206
- Schema version
- 2015v3.0
- 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 C
- Schedule D
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-02-28T15:46:16-06:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237076080 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRUSADERS CENTRAL CLINIC ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % SAMUEL MILLER CFO | InCareOfNm |
| Business Name Control | CRUS | BusinessNameControlTxt |
| Phone | 8154901600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WEST STATE STREET | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61102 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GORDON EGGERS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2017-02-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRUSADER COMMUNITY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GORDON EGGERS CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WEST STATE STREET | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,273,882 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CRUSADERHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | CRUSADER COMMUNITY HEALTH IS A COMMUNITY- BASED, NOT-FOR-PROFIT COMMUNITY HEALTH CENTER. SEE SCHEDULE O FOR MORE INFORMATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 378 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,947,989 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,219,001 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,220,839 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,011,063 | CYProgramServiceRevenueAmt |
| PY Investment Income | $48,035 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,040,933 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $2,885 | CYOtherRevenueAmt |
| PY Total Revenue | $40,216,863 | PYTotalRevenueAmt |
| CY Total Revenue | $42,273,882 | 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 | $21,548,570 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,344,493 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,872,971 | PYOtherExpensesAmt |
| CY Other Expenses | $13,375,941 | CYOtherExpensesAmt |
| PY Total Expenses | $34,421,541 | PYTotalExpensesAmt |
| CY Total Expenses | $36,720,434 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,795,322 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,553,448 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,596,081 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,628,689 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,392,073 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,862,030 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $42,204,008 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $47,766,659 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CRUSADER COMMUNITY HEALTH SERVES THE ROCK RIVER VALLEY AREA WITH QUALITY PRIMARY CARE FOR ALL PEOPLE IN NEED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $18,173,961 | ExpenseAmt |
| Revenue | $21,442,121 | RevenueAmt |
| Desc | CRUSADER COMMUNITY HEALTH'S MEDICAL SERVICE MODEL EMPHASIZES HIGH QUALITY SERVICES, CONTINUITY OF CARE, EFFICIENT OPERATIONS, AND CONTINUOUS IMPROVEMENT. THE MEDICAL DEPARTMENT OFFERS A FULL ARRAY OF PRIMARY MEDICAL CARE SERVICES FOR PATIENTS OF ALL AGES. MEDICAL SERVICES ARE FOCUSED IN THE AREAS OF PEDIATRICS, FAMILY PRACTICE, INTERNAL MEDICINE, SPECIALTY SERVICES, AND WOMEN'S HEALTH. SEE SCHEDULE O FOR ADDITIONAL PROGRAM DESCRIPTIONS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,031,837 | ExpenseAmt |
| Revenue | $7,628,161 | RevenueAmt |
| Desc | A FULL-SERVICE PHARMACY WAS AVAILABLE WITHIN EACH ROCKFORD LOCATION. THE CRUSADER COMMUNITY HEALTH PHARMACY OFFERED PATIENTS ACCESS TO LOW COST PRESCRIPTION MEDICATIONS. IN AN EFFORT TO EXPAND AFFORDABLE ACCESS TO PRESCRIPTION MEDICATIONS, CRUSADER ENTERED INTO AN AGREEMENT TO SELL ITS IN-HOUSE PHARMACIES TO WALGREENS DURING FISCAL YEAR 2016. CRUSADER PATIENTS MAY NOW ACCESS AFFORDABLE PHARMACEUTICALS AT MORE CONVENIENT LOCATIONS AND TIMES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,837,321 | ExpenseAmt |
| Revenue | $2,758,154 | RevenueAmt |
| Desc | CRUSADER COMMUNITY HEALTH'S DENTAL PROGRAM'S FOCUS IS ON PREVENTIVE EXAMS WHILE ALSO PROVIDING FILLINGS, CLEANINGS AND EMERGENCY TREATMENT FOR CHILDREN AND ADULTS. DENTAL SERVICES FOR CHILDREN ARE AVAILABLE AT ALL CRUSADER COMMUNITY HEALTH LOCATIONS. ADULT SERVICES ARE CURRENTLY OFFERED AT THE WEST STATE STREET AND BROADWAY LOCATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,868,127 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,182,627 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $27,911,246 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | 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 | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | 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 | Yes (true) | 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 |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 378 | 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 | false | QuidProQuoContributionsInd |
| 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 | 12 | 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 | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SAMUEL MILLER CFO | PersonNm |
| Phone | 8154901600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WEST STATE STREET | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61102 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| REBECCA ALSING | |||||||||
| CHAIR PROGRAM QUALITY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JUDITH BARRERA TULIAN | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| CATHERINE BROWN | |||||||||
| DIRECTOR END 12/15 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| LEON HANSEN | |||||||||
| CHAIR OPERATIONS | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PAUL HARRIS | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| BARBARA HUFFMAN | |||||||||
| IMMEDIATE PAST CHAIR END 1/16 | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TRACY RICHTER | |||||||||
| CHAIR ELECT | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID RUFFIN | |||||||||
| CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TRISH SINGER | |||||||||
| DIRECTOR END 12/15 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| TODD STEFFEN | |||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BARBARA WILLIAMS | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| EDUARDO VALDEZ | |||||||||
| CHAIR ELECT | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LUZ RAMIREZ | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD WALSH | |||||||||
| DIRECTOR BEGIN 6/16 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| CATHERINE FOSSE | |||||||||
| DIRECTOR BEG 1/16 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SAM MILLER | |||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $170,370 | $0 | $36,549 | |||
| GORDON EGGERS | |||||||||
| CEO | 40.0 | 0.0 | Yes (X) | $324,442 | $0 | $40,053 | |||
| TERRY WHITE | |||||||||
| COO | 40.0 | 0.0 | $151,207 | $0 | $11,817 | Yes (X) | |||
| DAWN MELLISH | |||||||||
| CMO | 40.0 | 0.0 | $279,597 | $0 | $0 | Yes (X) | |||
| ANTOUN Y AL KHABBAZ | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $433,467 | $0 | $44,285 | Yes (X) | |||
| LARRY SY | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $200,799 | $0 | $39,040 | Yes (X) | |||
| ANSELMA RAMILO | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $215,508 | $0 | $32,531 | Yes (X) | |||
| OLESYA BRANDIS | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $254,040 | $0 | $23,968 | Yes (X) | |||
| ZAKERA NANABAWA | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $295,393 | $0 | $20,105 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,324,823 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $248,348 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 43 | 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)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| HEALTH CARE SERVICES CORPORATION | |
| HEALTH CARE SERVICES | $2,142,590 |
| ROCKFORD STRUCTURES CONSTRUCTION CO | |
| CONSTRUCTION | $1,607,359 |
| ECLINICALWORKS LLC | |
| EMR MAINTENANCE | $487,388 |
| REMEDIES RENEWING LIVES | |
| BEHAVIORAL HEALTH | $421,420 |
| FURST STAFFING SERVICES | |
| STAFFING AGENCY | $289,392 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $941,569 | RelatedOrganizationsAmt |
| Government Grants | $6,957,435 | GovernmentGrantsAmt |
| All Other Contributions | $319,997 | AllOtherContributionsAmt |
| Noncash Contributions | $79,766 | NoncashContributionsAmt |
| Total Contributions | $8,219,001 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $30,974,334 | $30,974,334 |
| MANAGEMENT FEES | 624100 | $177,471 | $177,471 |
| OTHER REVENUE | 624100 | $16,081 | $16,081 |
| EHR & INCENTIVE REVENUE | 624100 | $873,711 | $873,711 |
| CAPITATION REVENUE | 624100 | $969,466 | $969,466 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,011,063 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $514,933 | TotalRevenueColumnAmt |
| Exclusion | $514,933 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,885 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,885 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,885 | TotalRevenueColumnAmt |
| Exclusion | $2,885 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $526,000 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $526,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $526,000 | TotalRevenueColumnAmt |
| Exclusion | $526,000 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,273,882 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,011,063 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,043,818 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,014,035 | TotalAmt |
| Program Services | $409,819 | ProgramServicesAmt |
| Management And General | $604,216 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,056 | TotalAmt |
| Program Services | $21,056 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,816,155 | TotalAmt |
| Program Services | $15,364,958 | ProgramServicesAmt |
| Management And General | $3,451,197 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,084 | TotalAmt |
| Program Services | $298,940 | ProgramServicesAmt |
| Management And General | $55,144 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,685,677 | TotalAmt |
| Program Services | $1,391,594 | ProgramServicesAmt |
| Management And General | $294,083 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,453,486 | TotalAmt |
| Program Services | $1,161,033 | ProgramServicesAmt |
| Management And General | $292,453 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,557 | TotalAmt |
| Management And General | $172,557 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,974 | TotalAmt |
| Management And General | $80,974 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,628,633 | TotalAmt |
| Program Services | $1,308,628 | ProgramServicesAmt |
| Management And General | $2,320,005 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,168 | TotalAmt |
| Management And General | $60,168 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,307 | TotalAmt |
| Program Services | $90,944 | ProgramServicesAmt |
| Management And General | $143,363 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,122 | TotalAmt |
| Program Services | $233,741 | ProgramServicesAmt |
| Management And General | $37,381 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $620,767 | TotalAmt |
| Program Services | $456,535 | ProgramServicesAmt |
| Management And General | $164,232 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,918 | TotalAmt |
| Program Services | $2,984 | ProgramServicesAmt |
| Management And General | $214,934 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,729 | TotalAmt |
| Program Services | $109,822 | ProgramServicesAmt |
| Management And General | $52,907 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448 | TotalAmt |
| Management And General | $448 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,937,185 | TotalAmt |
| Program Services | $1,450,867 | ProgramServicesAmt |
| Management And General | $486,318 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $3,518,733 | $3,518,733 | |
| BAD DEBT | $1,630,186 | $1,630,186 | |
| REPAIRS & MAINTENANCE | $607,282 | $432,014 | $175,268 |
| LICENSES, DUES, SUBSCRIPTIONS | $218,102 | $14,562 | $203,540 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,830 | TotalAmt |
| Program Services | $14,830 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,720,434 | TotalAmt |
| Program Services | $27,911,246 | ProgramServicesAmt |
| Management And General | $8,809,188 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,849,044 | BOYAmt |
| EOY | $10,924,003 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $952,064 | BOYAmt |
| EOY | $604,533 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,690 | BOYAmt |
| EOY | $5,966 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,703,073 | BOYAmt |
| EOY | $2,711,444 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $312,947 | BOYAmt |
| EOY | $23,288 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,369 | BOYAmt |
| EOY | $184,495 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,622,754 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,774,025 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,571,389 | BOYAmt |
| EOY | $13,848,729 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,228,937 | BOYAmt |
| EOY | $19,756,071 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,788,568 | BOYAmt |
| EOY | $4,570,160 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,596,081 | BOYAmt |
| EOY | $52,628,689 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,715,266 | BOYAmt |
| EOY | $4,470,058 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $676,807 | BOYAmt |
| EOY | $391,972 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,392,073 | BOYAmt |
| EOY | $4,862,030 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,956,170 | BOYAmt |
| EOY | $44,666,066 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,340,227 | BOYAmt |
| EOY | $2,224,656 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,611 | BOYAmt |
| EOY | $875,937 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,204,008 | BOYAmt |
| EOY | $47,766,659 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,596,081 | BOYAmt |
| EOY | $52,628,689 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,553,448 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $9,203 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | Yes (true) | VolunteersInd |
| Paid Staff Or Management | Yes (true) | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | Yes (true) | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Rallies Demonstrations | Yes (true) | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $27,600 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $27,600 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE C, PART II-B, QUESTION 1A, 1B, 1D, 1G & 1H | LOBBYING ACTIVITIES: PERIODICALLY, MANAGEMENT AND BOARD MEMBERS WRITE LETTERS AND MAKE PRESENTATIONS ON HEALTH CARE RELATED MATTERS TO EDUCATE ELECTED OFFICIALS AND THE PUBLIC. A DE MINIMIS AMOUNT OF FUNDS ARE SPENT ON THESE ACTIVITIES (LESS THAN $5,000). |
| SCHEDULE C, PART II-B QUESTION 1I | OTHER LOBBYING: THE ORGANIZATION PAYS DUES TO NACHC AND IPHCA AND MEDICAL PROFESSIONAL ASSOCIATION. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING PURPOSES. THE ORGANIZATION CONTRACTED WITH LARGENT GOVERNMENT SOLUTIONS, LLC TO REPRESENT THE ORGANIZATION'S INTERESTS IN LEGISLATIVE, REGULATORY AND ADMINISTRATIVE MATTERS. FEES PAID TO LARGENT TOTALED $27,600. |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,584,127 | OtherCostOrOtherBasisAmt |
| Book Value | $1,584,127 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,540,084 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,662,836 | DepreciationAmt |
| Book Value | $9,877,248 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,902,894 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,578,765 | DepreciationAmt |
| Book Value | $1,324,129 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,595,649 | OtherCostOrOtherBasisAmt |
| Depreciation | $532,424 | DepreciationAmt |
| Book Value | $1,063,225 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,848,729 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Interest in Net Assets of CHF | $3,100,593 |
| Other Receivables | $1,469,567 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,570,160 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $40,800,144 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$1,473,738 | OtherRevenueAmt |
| Revenue Not Reported | -$1,473,738 | RevenueNotReportedAmt |
| Revenue Subtotal | $42,273,882 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $42,273,882 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $35,090,248 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $35,090,248 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,630,186 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,630,186 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $36,720,434 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (1,630,186) BAD DEBT EXPENSE 156,448 NET ASSETS RELEASED FROM RESTRICTION ------------- $ (1,473,738) |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 1,630,186 BAD DEBT EXPENSE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SAM MILLER | ||||||||||||||
| CFO | $137,950 | $0 | $20,538 | $0 | $11,882 | $0 | $8,231 | $0 | $28,318 | $0 | $206,919 | $0 | $0 | $0 |
| GORDON EGGERS | ||||||||||||||
| CEO | $224,022 | $0 | $27,525 | $0 | $72,895 | $0 | $11,925 | $0 | $28,128 | $0 | $364,495 | $0 | $0 | $0 |
| ANTOUN Y AL KHABBAZ | ||||||||||||||
| PHYSICIAN | $393,645 | $0 | $25,556 | $0 | $14,266 | $0 | $11,925 | $0 | $32,360 | $0 | $477,752 | $0 | $0 | $0 |
| LARRY SY | ||||||||||||||
| PHYSICIAN | $192,939 | $0 | $7,410 | $0 | $450 | $0 | $9,412 | $0 | $29,628 | $0 | $239,839 | $0 | $0 | $0 |
| ANSELMA RAMILO | ||||||||||||||
| PHYSICIAN | $205,010 | $0 | $7,992 | $0 | $2,506 | $0 | $9,921 | $0 | $22,610 | $0 | $248,039 | $0 | $0 | $0 |
| OLESYA BRANDIS | ||||||||||||||
| PHYSICIAN | $244,443 | $0 | $9,363 | $0 | $234 | $0 | $0 | $0 | $23,968 | $0 | $278,008 | $0 | $0 | $0 |
| ZAKERA NANABAWA | ||||||||||||||
| PHYSICIAN | $273,588 | $0 | $21,583 | $0 | $222 | $0 | $8,769 | $0 | $11,336 | $0 | $315,498 | $0 | $0 | $0 |
| TERRY WHITE | ||||||||||||||
| COO | $144,054 | $0 | $5,656 | $0 | $1,497 | $0 | $6,782 | $0 | $5,035 | $0 | $163,024 | $0 | $0 | $0 |
| DAWN MELLISH | ||||||||||||||
| CMO | $258,654 | $0 | $20,000 | $0 | $943 | $0 | $0 | $0 | $0 | $0 | $279,597 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | SOCIAL CLUB DUES: THE ORGANIZATION REIMBURSED GORDON EGGERS, PRESIDENT/CEO $1,510 DUES TO THE UNIVERSITY CLUB OF ROCKFORD. THE SPOUSE OF THE CEO PERIODICALLY TRAVELS WITH THE CEO WHILE THE CEO IS TRAVELING ON ORGANIZATION BUSINESS. THE ORGANIZATION REIMBURSED THE CEO FOR SPOUSE TRAVEL COSTS TOTALING $383. THESE BENEFITS ARE ONLY PROVIDED TO THE CEO. THE AMOUNT REIMBURSED IS SUBSTANTIATED AND INCLUDED ON HIS W-2. |
| SCHEDULE J, PART I, QUESTIONS 6A & 7 | BONUSES: A PORTION OF THE CEO'S PERFORMANCE INCENTIVE IS BASED ON ACHIEVING CERTAIN FINANCIAL PERFORMANCE. THE CFO RECEIVED A DISCRETIONARY PERFORMANCE INCENTIVE. IN ADDITION, MEDICAL PROVIDERS WERE GRANTED A BONUS THAT WAS NOT TIED TO ANY PERFORMANCE GOALS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROSE EGGERS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SPOUSE OF G. EGGERS | RelationshipDescriptionTxt |
| Transaction | $21,056 | TransactionAmt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV | FormAndLineReferenceDesc |
| Explanation | BUSINESS TRANSACTION INVOLVING INTERESTED PERSONS: ROSE EGGERS IS THE SPOUSE OF GORDON EGGERS, PRESIDENT & CEO. SHE IS A PART-TIME NURSE PRACTITIONER FOR THE ORGANIZATION. THE AMOUNT OF THE TRANSACTION REPORTED ON SCHEDULE L, PART IV, COLUMN D, REPRESENTS THE AMOUNT PAID IN SALARY AND BENEFITS. THE COMPENSATION AMOUNT PAID IS REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS TO ENSURE IT IS IN COMPLIANCE WITH THE ORGANIZATION'S COMPENSATION SETTING POLICIES. | ExplanationTxt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $79,766 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, LINE 20 | FormAndLineReferenceDesc |
| Explanation | PHARMACEUTICAL DONATIONS: THE ORGANIZATION RECEIVED DONATIONS FROM THREE VENDORS DURING FISCAL YEAR 2016. THE CONTRIBUTIONS WERE VARIOUS DONATED PHARMACEUTICALS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION GENERAL INFORMATION: SINCE 1972, CRUSADER COMMUNITY HEALTH HAS STRIVED TO ENSURE THAT ALL PERSONS IN OUR COMMUNITY HAVE ACCESS TO QUALITY, PRIMARY HEALTH CARE. CRUSADER COMMUNITY HEALTH IS A COMMUNITY-BASED, NOT-FOR-PROFIT CORPORATION, WHOSE MISSION IS TO SERVE THE NORTHWEST ILLINOIS AREA WITH QUALITY, PRIMARY HEALTH CARE FOR ALL PEOPLE IN NEED. CRUSADER COMMUNITY HEALTH PLAYS A VITAL HEALTH CARE ROLE IN THIS COMMUNITY, SERVING PATIENTS UNABLE TO AFFORD THE RISING COST OF HEALTH CARE. WHILE THERE ARE NO RESTRICTIONS ON WHO CAN UTILIZE ITS SERVICES, CRUSADER SPECIALIZES IN SERVING MEDICALLY UNDERSERVED INDIVIDUALS - THE HOMELESS, FAMILIES IN POVERTY, HIGH-RISK PREGNANT WOMEN, PERSONS WITH HIV/AIDS, THE ELDERLY AND THOSE WITH CHRONIC DISEASES. WITHOUT CRUSADER, A BROAD AND GROWING SEGMENT OF THE COMMUNITY WOULD FAIL TO RECEIVE THE PRIMARY HEALTH CARE THAT REDUCES THE COST OF CATASTROPHIC ILLNESS. MEDICAL SERVICES ARE PROVIDED ON AN AFFORDABLE SLIDING DISCOUNT BASIS AND INTEGRATE HEALTH PROMOTION AND DISEASE PREVENTION INTO A PROGRAM OF COMPREHENSIVE HEALTH CARE. |
| FORM 990, PART III, LINE 3 | SIGNIFICANT CHANGE IN PROGRAM SERVICES: CRUSADER COMMUNITY HEALTH ENTERED INTO AN AGREEMENT TO SELL ITS IN-HOUSE PHARMACIES TO WALGREENS. |
| FORM 990, PART III, LINE 4A | MEDICAL SERVICES: PEDIATRICS THE PEDIATRIC DEPARTMENT OFFERS A WIDE RANGE OF SERVICES FOR CHILDREN, INCLUDING CARE FOR NEWBORNS THROUGH ADOLESCENCE. CRUSADER COMMUNITY HEALTH UTILIZES BOARD-CERTIFIED PEDIATRICIANS, FAMILY PRACTITIONERS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO DELIVER CARE FOR CHILDREN. SOME OF THE SERVICES AVAILABLE INCLUDE: IMMUNIZATIONS, WELL-CHILD CHECKS, LEAD SCREENING, ATTENTION DEFICIT DISORDER (ADD), ASTHMA EDUCATION AND TREATMENT AND MEDICAL TREATMENT FOR ACUTE CONDITIONS. TO BETTER SERVE PEDIATRIC PATIENTS, CRUSADER ESTABLISHED A WALK-IN CLINIC AT THE BROADWAY LOCATION. FOR ADULT PATIENTS, CRUSADER PROVIDES PREVENTIVE CARE AND DIAGNOSIS AND TREATMENT FOR A WIDE RANGE OF ACUTE AND CHRONIC DISEASES. CARE IS DELIVERED THROUGH A TEAM OF BOARD-CERTIFIED MEDICAL PROVIDERS. SOME OF THE SPECIFIC SERVICES AVAILABLE INCLUDE: CHRONIC DISEASE MANAGEMENT, MEDICAL TREATMENT FOR ACUTE CONDITIONS, PHYSICALS, DIABETES EDUCATION AND TREATMENT, HEALTH EDUCATION SERVICES, ASTHMA EDUCATION AND TREATMENT, IMMUNIZATIONS, LABORATORY SERVICES, MINOR INJURY CARE. WOMEN'S HEALTH SERVICES WOMEN'S HEALTH SERVICES DEPARTMENT PROVIDES PRENATAL CARE, WELLNESS EXAMS, CANCER SCREENING AND FOLLOW-UP, AND GYNECOLOGIC SERVICES. SERVICES ARE PROVIDED BY A TEAM OF OBSTETRICIANS, FAMILY PRACTITIONERS, CERTIFIED NURSE MID-WIVES AND NURSE PRACTITIONERS. SPECIALTY SERVICES A WIDE RANGE OF SPECIALTY SERVICES ARE AVAILABLE TO CRUSADER COMMUNITY HEALTH PATIENTS, SOME OF WHICH INCLUDE: PODIATRY, PAIN MANAGEMENT, SUBSTANCE ABUSE COUNSELING, MENTAL HEALTH, AND INFECTIOUS DISEASE. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: CRUSADER COMMUNITY HEALTH PROVIDES OTHER PROGRAMS THROUGH ITS ANCILLARY AND COMMUNITY SERVICES AS OUTLINED BELOW. HIV SERVICES SINCE 1991, THE LIVING WITH HIV PROGRAM OF CRUSADER COMMUNITY HEALTH HAS PROVIDED SERVICES TO INDIVIDUALS WITH HIV/AIDS. EMBRACING THE GOAL OF ASSURING CLIENT ACCESS TO MEDICAL CARE, THE PROGRAM ALSO PROVIDES ASSISTANCE WITH TRANSPORTATION, LINKAGE TO SOCIAL SERVICE PROGRAMS, COUNSELING, PSYCHIATRIC SERVICES, AND OBTAINING MEDICATIONS. SERVICES ARE PRIMARILY PROVIDED AT CRUSADER COMMUNITY HEALTH ON WEST STATE STREET. SERVICES ARE OFFERED CONFIDENTIALLY IN A CARING AND SUPPORTIVE ENVIRONMENT. IN ADDITION TO PROVIDING SERVICES THROUGH ITS PHYSICIAN STAFF, CRUSADER COMMUNITY HEALTH CONTRACTS WITH ROCKFORD INFECTIOUS DISEASE ASSOCIATES TO PROVIDE ADDITIONAL SUPPORT. OTHER SERVICES ARE OFFERED THROUGH A NURSE PRACTITIONER, NURSES, CASE MANAGERS, A LICENSED CLINICAL SOCIAL WORKER, AND A CONTRACTED PSYCHIATRIST. HOMELESS SERVICES CRUSADER COMMUNITY HEALTH'S HEALTH CARE FOR THE HOMELESS PROGRAM WAS ESTABLISHED IN 1988. ITS MISSION IS TO PROVIDE COMPREHENSIVE MEDICAL CARE FOR HOMELESS INDIVIDUALS WITHIN THE ROCKFORD AREA. THE PROGRAM CONSISTS OF PHYSICIANS, DENTISTS, NURSE PRACTITIONERS, NURSES AND CASE MANAGERS COMMITTED TO HELPING CLIENTS ACCESS MEDICAL SERVICES. SERVICES ARE PROVIDED WITHIN CRUSADER COMMUNITY HEALTH AND AT A VARIETY OF SITES THROUGHOUT THE COMMUNITY. HEALTH EDUCATION THE HEALTH EDUCATION DEPARTMENT OFFERS INTENSIVE CASE MANAGEMENT SERVICES FOR PATIENTS LIVING WITH CHRONIC DISEASES INCLUDING DIABETES, ASTHMA, CONGESTIVE HEART FAILURE (CHF), AND OBESITY (WEIGHT MANAGEMENT). THE DEPARTMENT OFFERS EDUCATION SERVICES IN BOTH A CLASSROOM SETTING AND ONE-TO-ONE SESSIONS IN BOTH ENGLISH AND SPANISH. THE CLINICAL STAFF OF THE PROGRAM INCLUDES A NURSE WHO IS A CERTIFIED DIABETES EDUCATOR AND REGISTERED DIETITIANS. THE DEPARTMENT OFFERS COMMUNITY PROGRAMS THROUGHOUT THE AREA(PRIMARILY WINNEBAGO, BOONE AND STEPHENSON COUNTIES). COMMUNITY SERVICES INCLUDE BLOOD GLUCOSE SCREENINGS FOR DIABETES THROUGH THE COSMOPOLITAN / CRUSADER COMMUNITY HEALTH MOBILE DIABETES PROGRAM AND PUBLIC SPEAKING ENGAGEMENTS ON A VARIETY OF HEALTH RELATED TOPICS. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS FOR 990 REVIEW: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CFO REVIEWS THE FORM 990. A FINAL DRAFT OF THE RETURN IS EMAILED TO ALL BOARD MEMBERS BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST MONITORING: THE CORPORATION SHALL PROHIBIT STAFF MEMBERS, CONSULTANTS OR MEMBERS OF THE BOARD OF DIRECTORS FROM USING THEIR POSITION FOR PURPOSES THAT ARE, OR GIVE THE APPEARANCE OF BEING, MOTIVATED BY A DESIRE FOR PRIVATE FINANCIAL GAIN FOR THEMSELVES OR OTHERS WITH WHOM THEY HAVE FAMILY BUSINESS OR OTHER TIES. BOARD MEMBERS AND EXECUTIVE MANAGEMENT SHALL DISCLOSE IN WRITING (AND UPDATE YEARLY) ALL BUSINESS AND FAMILY RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT. IN ADDITION, THE INDIVIDUAL STAFF MEMBER WITH AN ACTUAL OR POTENTIAL CONFLICT SHALL BE PROHIBITED FROM INVOLVEMENT IN THE SELECTION, AWARD AND ADMINISTRATION OF ANY SUCH CONTRACT; A CONFLICTED BOARD MEMBER SHALL DISQUALIFY HIMSELF/HERSELF FROM VOTING AND COMMENTING ON THE CONTRACTOR'S SELECTION AND ANY MONITORING OR OVERSIGHT FUNCTION. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | PROCESS FOR DETERMINING COMPENSATION: ANNUALLY THE CEO'S COMPENSATION REVIEW WAS CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE BOARD, WITH APPROVAL BY THE FULL BOARD. THE IPHCA, MGMA AND NACHC COMPENSATION SURVEYS WERE USED AS COMPARABILITY DATA. THE PROCESS WAS DOCUMENTED IN A REPORT REFERENCED BY THE EXECUTIVE COMMITTEE MINUTES AND THE BOARD MINUTES OF THE ORGANIZATION. IN ADDITION, ANNUALLY, THE OTHER OFFICER'S AND KEY EMPLOYEES' COMPENSATION REVIEWS WERE CONDUCTED BY THE CEO, WITH APPROVAL BY THE EXECUTIVE COMMITTEE OF THE BOARD, OF THE PROCESS USED TO ESTABLISH THEIR COMPENSATION. THE IPHCA AND NACHC COMPENSATION SURVEY WERE USED AS COMPARABILITY DATA. THE PROCESS WAS DOCUMENTED BY THE CEO AND THE EXECUTIVE COMMITTEE APPROVAL WAS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | DISCLOSURE OF DOCUMENTS: THE ORGANIZATION WOULD MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS WOULD BE AVAILABLE FOR VIEWING AT THE ORGANIZATION'S OFFICE. |
| FORM 990, PART XI, LINE 9 | OTHER RECONCILIATION ITEMS: $ 40,877 CHANGE IN INTEREST IN NET ASSETS OF CHF - TEMPORARY (31,674) CHANGE IN INTEREST IN NET ASSETS OF CHF - PERMANENT ---------- $ 9,203 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRUSADERS HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WEST STATE STREET | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363259761 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C) (3) | ExemptCodeSectionTxt |
| Public Charity Status | 11A III-FI | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |