NORTH SHORE COMMUNITY HEALTH INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- NORTH SHORE COMMUNITY HEALTH INC (EIN 04-2610447)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201721359349308702
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T14:25:31-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | 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 | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042610447 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH SHORE COMMUNITY HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 9788251109 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 CONGRESS ST NO 504 | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01970 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET BRENNAN | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 9788251109 | PhoneNum |
| Signature | 2017-05-15 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARGARET BRENNAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 CONGRESS ST NO 504 | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01970 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,831,796 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NSCHI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | NORTH SHORE COMMUNITY HEALTH'S MISSION IS TO BUILD HEALTHY COMMUNITIES BY PROVIDING EXCEPTIONAL CARE TO ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 148 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,919,087 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,722,271 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,359,112 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,894,174 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$77,448 | PYInvestmentIncomeAmt |
| CY Investment Income | $111 | CYInvestmentIncomeAmt |
| PY Other Revenue | $176,319 | PYOtherRevenueAmt |
| CY Other Revenue | $215,240 | CYOtherRevenueAmt |
| PY Total Revenue | $12,377,070 | PYTotalRevenueAmt |
| CY Total Revenue | $12,831,796 | 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 | $8,436,016 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,372,848 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,591,019 | PYOtherExpensesAmt |
| CY Other Expenses | $4,055,584 | CYOtherExpensesAmt |
| PY Total Expenses | $13,027,035 | PYTotalExpensesAmt |
| CY Total Expenses | $12,428,432 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$649,965 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $403,364 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,656,575 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,400,367 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,709,079 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,049,507 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,947,496 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,350,860 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE HEALTH CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE PRIMARY CARE THAT IS ACCESSIBLE, CULTURALLY AND LINGUISTICALLY COMPETENT, AND COMMUNITY DIRECTED FOR ALL RESIDENTS OF MASSACHUSETTS' NORTH SHORE AND CAPE ANN COMMUNITIES REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,181,763 | ExpenseAmt |
| Revenue | $6,363,440 | RevenueAmt |
| Desc | MEDICAL SERVICES - MEDICAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. SERVICES INCLUDE MEDICAL SERVICES TO ADULTS AND CHILDREN, HIV COUNSELING AND OTHER. THERE WERE 41,341 MEDICAL VISITS DURING THE TAX YEAR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,897,472 | ExpenseAmt |
| Revenue | $1,663,032 | RevenueAmt |
| Desc | DENTAL SERVICES - DENTAL SERVICES PROVIDED TO THE RESIDENTS OF SALEM, PEABODY, GLOUCESTER AND SURROUNDING COMMUNITIES. THERE WERE 16,432 DENTAL VISITS DURING THE TAX YEAR. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $273,288 | ExpenseAmt |
| Revenue | $76,942 | RevenueAmt |
| Desc | SCHOOL BASED HEALTH CENTERS - HEALTH SERVICES WERE PROVIDED TO STUDENTS AT SALEM AND PEABODY VETERAN MEMORIAL HIGH SCHOOLS. THERE WERE 1,716 SCHOOL BASED HEALTH CENTER VISITS DURING THE TAX YEAR. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,352,523 | 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 | 0 | 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 | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 148 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARGARET BRENNAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9788251109 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 CONGRESS ST NO 504 | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01970 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|
| CHARLOTTE OHANNESSIAN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GABRIELLE ROSS | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GINA FLYNN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JACK VONDRAS | |||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOHN BELCHERS | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LUCY CORCHADO | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARION WINFREY | |||||||
| IMMEDIATE PAST PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MATTHEW VENO | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL BABB | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAMELA PAINE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RITA BADAMI | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ROBERT TOLU | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEPHEN MEUNIER | |||||||
| OUTGOING BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| VENTURA LOREDO | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| FAITH BAIGELMAN | |||||||
| CFO | 40.00 | $14,407 | $0 | $1,742 | Yes (X) | ||
| MARGARET BRENNAN | |||||||
| CEO | 40.00 | $182,471 | $0 | $21,143 | Yes (X) | ||
| SYLVIA CARTER | |||||||
| INTERIM CFO | 40.00 | $100,782 | $0 | $0 | Yes (X) | ||
| THOMAS DOWLEY | |||||||
| CFO THRU 6/15 | 40.00 | $75,649 | $0 | $5,673 | Yes (X) | ||
| AZRA ALI | |||||||
| FAMILY PRACTICE PHYSICIAN | 40.00 | $180,907 | $0 | $0 | Yes (X) | ||
| CHITRA VIJAYARAGHAVAN | |||||||
| PHYSICIAN | 40.00 | $162,332 | $0 | $21,084 | Yes (X) | ||
| DAMIAN ARCHER | |||||||
| CMO | 40.00 | $167,673 | $0 | $7,527 | Yes (X) | ||
| KIAME MAHANIAH | |||||||
| CMO | 40.00 | $147,469 | $0 | $19,330 | Yes (X) | ||
| RODRIGO TAVARES RODRIGUES | |||||||
| INTERNAL MEDICINE/PEDIATRICIAN | 40.00 | $192,890 | $0 | $475 | Yes (X) | ||
| STEPHEN F KULCSAR | |||||||
| FAMILY PRACTICE PHYSICIAN | 40.00 | $163,137 | $0 | $7,966 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,387,717 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $84,940 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PRIORITY MANAGEMENT GROUP INC | |||||
| 700 SCHOOL STREET | PAWTUCKET | RI | 02806 | PATIENT BILLING SERVICES | $469,093 |
| NORTH SHORE PHYSICIANS GROUP | |||||
| TWO CORPORATE WAY SUITE 180 | PEABODY | MA | 01960 | OB/GYN PROVIDER SERVICES | $148,941 |
| INSOURCE SERVICES INC | |||||
| PO BOX 427 | NEWTON | MA | 02464 | IT SERVICES | $121,366 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,776,003 | GovernmentGrantsAmt |
| All Other Contributions | $946,268 | AllOtherContributionsAmt |
| Total Contributions | $4,722,271 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID | 621110 | $4,224,528 | $4,224,528 |
| PHARMACY REVENUE | 621110 | $1,483,869 | $1,483,869 |
| HEALTH SAFETY NET | 621110 | $1,086,302 | $1,086,302 |
| MEDICARE | 621110 | $589,498 | $589,498 |
| THIRD-PARTY PAYORS | 621110 | $439,620 | $439,620 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,357 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,357 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,894,174 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111 | TotalRevenueColumnAmt |
| Exclusion | $111 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | 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 | $6,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,000 | TotalRevenueColumnAmt |
| Exclusion | $6,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER INCOME | 621110 | $99,052 | $99,052 |
| MBHP | 621110 | $76,484 | $76,484 |
| INCENTIVE PAYMENTS | 621110 | $30,158 | $30,158 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,546 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,546 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $209,240 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,831,796 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,103,414 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,111 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $415,192 | TotalAmt |
| Program Services | $360,822 | ProgramServicesAmt |
| Management And General | $54,370 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,447,836 | TotalAmt |
| Program Services | $5,611,380 | ProgramServicesAmt |
| Management And General | $836,456 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,030,805 | TotalAmt |
| Program Services | $879,059 | ProgramServicesAmt |
| Management And General | $151,746 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $479,015 | TotalAmt |
| Program Services | $404,288 | ProgramServicesAmt |
| Management And General | $74,727 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,691 | TotalAmt |
| Program Services | $2,545 | ProgramServicesAmt |
| Management And General | $21,146 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,047 | TotalAmt |
| Management And General | $58,047 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $566,290 | TotalAmt |
| Program Services | $65,632 | ProgramServicesAmt |
| Management And General | $500,658 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,181 | TotalAmt |
| Program Services | $45,000 | ProgramServicesAmt |
| Management And General | $19,181 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,171 | TotalAmt |
| Program Services | $229,516 | ProgramServicesAmt |
| Management And General | $24,655 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,666 | TotalAmt |
| Program Services | $347,316 | ProgramServicesAmt |
| Management And General | $34,350 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $413,530 | TotalAmt |
| Program Services | $365,616 | ProgramServicesAmt |
| Management And General | $47,914 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,825 | TotalAmt |
| Program Services | $10,707 | ProgramServicesAmt |
| Management And General | $16,118 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,166 | TotalAmt |
| Program Services | $14,008 | ProgramServicesAmt |
| Management And General | $20,158 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,202 | TotalAmt |
| Program Services | $308,608 | ProgramServicesAmt |
| Management And General | $21,594 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,353 | TotalAmt |
| Program Services | $53,209 | ProgramServicesAmt |
| Management And General | $14,144 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| HOUSEKEEPING SERVICES A | $714,602 | $707,456 | $7,146 |
| PHARMACY AND RELATED FE | $682,344 | $682,344 | |
| MISCELLANEOUS | $157,219 | $59,280 | $97,939 |
| DUES AND SUBSCRIPTIONS | $122,300 | $48,920 | $73,380 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,997 | TotalAmt |
| Program Services | $156,817 | ProgramServicesAmt |
| Management And General | $2,180 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,428,432 | TotalAmt |
| Program Services | $10,352,523 | ProgramServicesAmt |
| Management And General | $2,075,909 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,942 | BOYAmt |
| EOY | $689,930 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,055 | BOYAmt |
| EOY | $205,447 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $810,230 | BOYAmt |
| EOY | $593,204 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,520,523 | BOYAmt |
| EOY | $1,293,141 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,816 | BOYAmt |
| EOY | $37,919 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,627 | BOYAmt |
| EOY | $28,347 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,862,057 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,309,678 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,860,382 | BOYAmt |
| EOY | $2,552,379 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,656,575 | BOYAmt |
| EOY | $5,400,367 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,622,722 | BOYAmt |
| EOY | $1,278,159 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,086,357 | BOYAmt |
| EOY | $771,348 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,709,079 | BOYAmt |
| EOY | $2,049,507 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,887,882 | BOYAmt |
| EOY | $2,457,502 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,059,614 | BOYAmt |
| EOY | $893,358 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,947,496 | BOYAmt |
| EOY | $3,350,860 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,656,575 | BOYAmt |
| EOY | $5,400,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $403,364 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,048,532 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,384,843 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,824,937 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,919,087 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,722,271 | CurrentTaxYearAmt |
| Total | $19,899,670 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,048,532 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,384,843 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,824,937 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,919,087 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,722,271 | CurrentTaxYearAmt |
| Total | $19,899,670 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,899,670 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,862 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,223 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,414 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,336 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,111 | CurrentTaxYearAmt |
| Total | $37,946 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $546,091 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $290,840 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $338,482 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $170,319 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $209,240 | CurrentTaxYearAmt |
| Total | $1,554,972 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,492,588 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $36,197,486 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.92590 | PublicSupportCY170Pct |
| Public Support PY170 | 0.87270 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2011 AMOUNT: $ 425,000. 2012 AMOUNT: $ 69,840. 2013 AMOUNT: $ 236,482. 2014 AMOUNT: $ 69,447. 2015 AMOUNT: $ 99,052. EMR INCENTIVE - 2011 AMOUNT: $ 121,091. 2012 AMOUNT: $ 221,000. 2013 AMOUNT: $ 102,000. 2014 AMOUNT: $ 93,500. 2015 AMOUNT: $ 30,158. MEDICAL RECORDS FEES - 2014 AMOUNT: $ 7,372. 2015 AMOUNT: $ 3,546. MBHP - 2015 AMOUNT: $ 76,484. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,415,592 | OtherCostOrOtherBasisAmt |
| Depreciation | $818,511 | DepreciationAmt |
| Book Value | $597,081 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,883,859 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,281,350 | DepreciationAmt |
| Book Value | $1,602,509 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,562,606 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,209,817 | DepreciationAmt |
| Book Value | $352,789 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,552,379 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,824,044 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $36,900 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$44,652 | OtherRevenueAmt |
| Revenue Not Reported | -$7,752 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,831,796 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,831,796 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,420,680 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $36,900 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $36,900 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,383,780 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $44,652 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $44,652 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,428,432 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2016 AND 2015. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2013 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CENTER HAS UNRELATED BUSINESS INCOME TAXES, IT WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS -44,652. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 44,652. |
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 | Yes (1) | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARGARET BRENNAN | ||||||||||||||
| CEO | $182,371 | $0 | $100 | $0 | $0 | $0 | $0 | $0 | $22,013 | $0 | $204,484 | $0 | $0 | $0 |
| AZRA ALI | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $180,807 | $0 | $100 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $180,907 | $0 | $0 | $0 |
| CHITRA VIJAYARAGHAVAN | ||||||||||||||
| PHYSICIAN | $162,332 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $21,084 | $0 | $183,416 | $0 | $0 | $0 |
| DAMIAN ARCHER | ||||||||||||||
| CMO | $167,572 | $0 | $101 | $0 | $0 | $0 | $0 | $0 | $7,527 | $0 | $175,200 | $0 | $0 | $0 |
| KIAME MAHANIAH | ||||||||||||||
| CMO | $147,469 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,330 | $0 | $166,799 | $0 | $0 | $0 |
| RODRIGO TAVARES RODRIGUES | ||||||||||||||
| INTERNAL MEDICINE/PEDIATRICIAN | $192,789 | $0 | $101 | $0 | $0 | $0 | $0 | $0 | $475 | $0 | $193,365 | $0 | $0 | $0 |
| STEPHEN F KULCSAR | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $163,036 | $0 | $101 | $0 | $0 | $0 | $0 | $0 | $7,966 | $0 | $171,103 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | THOMAS DOWLEY RECEIVED SEVERANCE PAY DURING CALENDAR YEAR 2015 OF $4808 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 INITIAL COMPLETION IS DONE BY OUR AUDITORS. THE FORM 990 IS THEN SENT TO THE NORTH SHORE COMMUNITY HEALTH MANAGEMENT TEAM AND THEN FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS, WHO ARE GIVEN A WEEK TO SUBMIT ANY QUESTIONS, COMMENTS, OR OBSERVATIONS THAT THEY HAVE. THEN MANAGEMENT DISCUSSES ANY CHANGES THEY ARE GOING TO MAKE TO THE 990 FORM. IF CHANGES ARE DEEMED NECESSARY, THEY ARE MADE IMMEDIATELY. THE FORM 990 IS THEN APPROVED FOR SUBMISSION BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH EMPLOYEE, VOLUNTEER, AND BOARD MEMBER WILL ACKNOWLEDGE THAT THEY HAVE READ AND UNDERSTAND NORTH SHORE COMMUNITY HEALTH'S CONFLICT OF INTEREST POLICY UPON BEGINNING THEIR EMPLOYMENT OR TENURE WITH NORTH SHORE COMMUNITY HEALTH BY SIGNING AN ACKNOWLEDGEMENT FORM. THIS IS UPDATED ON A YEARLY BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE HEALTH CENTER'S OFFICERS AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS UTILIZING A SALARY SURVEY. THE EXECUTIVE DIRECTOR SETS THE OTHER EMPLOYEES' SALARIES BASED ON A SALARY SURVEY IN ACCORDANCE WITH THE HEALTH CENTER'S BUDGET PARAMETERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NORTH SHORE COMMUNITY HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE TO THE GENERAL PUBLIC THROUGH WWW.GUIDESTAR.ORG. |
| FORM 990 XII LINE 2C EXPLANATION | THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AS WELL AS THE SELECTION OF THE INDEPENDENT ACCOUNTANT. |