HAMM MEMORIAL PSYCHIATRIC CLINIC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- HAMM MEMORIAL PSYCHIATRIC CLINIC (EIN 41-1649502)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2016-09-30
- IRS object ID
- 201642749349300114
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-09-30T09:50:03-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | 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 | 411649502 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAMM MEMORIAL PSYCHIATRIC CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAMM | BusinessNameControlTxt |
| Phone | 6512240614 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 ST PETER STREET NO 429 | AddressLine1Txt |
| City | ST PAUL | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55102 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN DWYER | PersonNm |
| Person Title | CHIEF OPERATING OFFICER | PersonTitleTxt |
| Phone | 6512240614 | PhoneNum |
| Signature | 2016-09-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENNIFER TINGLEY | PreparerPersonNm |
| PTIN | P01485570 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHEN DWYER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 ST PETER STREET NO 429 | AddressLine1Txt |
| City | ST PAUL | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,649,229 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HAMMCLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 34 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,728,767 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,744,925 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $840,852 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $899,391 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,987 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,913 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$14,660 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,560,946 | PYTotalRevenueAmt |
| CY Total Revenue | $2,649,229 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,000 | 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 | $1,953,968 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,063,724 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $48,488 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $469,903 | PYOtherExpensesAmt |
| CY Other Expenses | $486,783 | CYOtherExpensesAmt |
| PY Total Expenses | $2,433,871 | PYTotalExpensesAmt |
| CY Total Expenses | $2,550,507 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $127,075 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $98,722 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,282,026 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,265,798 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,121,065 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,449,916 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $160,961 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$184,118 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,472,882 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $874,121 | RevenueAmt |
| Desc | CLINICAL SERVICES: HAMM MEMORIAL PSYCHIATRIC CLINIC PROVIDES A VARIETY OF OUTPATIENT MENTAL HEALTH AND RELATED SERVICES TO ADULTS AND OPERATES IN THE TWIN CITIES METROPOLITAN AREA. THE CLINIC OFFERS A FULL SPECTRUM OF OUTPATIENT MENTAL HEALTH SERVICES IN ENGLISH AND SPANISH. THE CLINIC SEEKS TO TREAT SYMPTOMS AND ALSO TO HELP CLIENTS GAIN INSIGHT AND UNDERSTANDING INTO THEIR BEHAVIOR. THE CLINIC TEAM IS COMPRISED OF CLINICAL SOCIAL WORKERS, PSYCHOLOGISTS, AND PSYCHIATRISTS WORKING TOGETHER TO IMPROVE MENTAL HEALTH. IN FY16, 736 PATIENTS WERE SERVED TOTALING 9,063 VISITS TO THE CLINIC.ELECTRONIC HEALTH RECORDS (EHR) PROGRAM: THE CLINIC TRANSITIONED TO AN ELECTRONIC HEALTH RECORDS SYSTEM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $389,951 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | TRAINING AND PROFESSIONAL DEVELOPMENT: THE CLINIC'S TRAINING PROGRAM PROVIDES SPECIALIZED TRAINING AND EDUCATION FOR GRADUATES AND POST-GRADUATES IN CLINICAL SOCIAL WORK, PSYCHOLOGY, AND PSYCHIATRY. THE CLINIC'S COMPREHENSIVE APPROACH TO TRAINING ENABLES STUDENTS TO PROVIDE DIRECT CLIENT CARE UNDER CLOSE SUPERVISION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $68,169 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | RESEARCH AND PUBLICATION: THE CLINIC CONDUCTS EFFECTIVENESS RESEARCH. EFFECTIVENESS RESEARCH SEEKS TO DETERMINE WHETHER THE TREATMENT AT THE CLINIC IS EFFECTIVE IN A COMMUNITY MENTAL HEALTH CENTER SETTING WITH A VARIETY OF CLIENTS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $57,712 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $25,270 | RevenueAmt |
| Desc | OUTREACH: ANNUAL CONFERENCE | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $57,712 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $25,270 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $1,988,714 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 34 | 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD BOURMAN CONTROLLER | PersonNm |
| Phone | 6512240614 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 ST PETER STREET SUITE 429 | AddressLine1Txt |
| City | ST PAUL | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55102 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| JAMES F HART MD | ||||||
| BOARD PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ELIZABETH WITTENBERG | ||||||
| BOARD VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ABBY DAWKINS | ||||||
| BOARD SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| HENRY STOCKMAN | ||||||
| BOARD TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DINA RAUKER | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| VICTORIA COIFMAN | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MELANIE FERRIS | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ALAN FLEISCHAUER | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ANNE R GEARITY | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| EDWARD H HAMM | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| EDWARD H HAMM III | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JACK MILITELLO | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MICKEY MULCAHY | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KELLEY O'NEILL | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PAULA RICHEY | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TONI MAGNUSON MD | ||||||
| PSYCHIATRIST, MD | 32.00 | Yes (X) | $93,076 | $0 | $12,112 | |
| STEPHEN DWYER | ||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $104,114 | $0 | $3,491 | |
| RICHARD BOURMAN | ||||||
| CONTROLLER | 27.00 | Yes (X) | $72,555 | $0 | $1,673 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $269,745 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $17,276 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,744,925 | AllOtherContributionsAmt |
| Total Contributions | $1,744,925 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 621400 | $874,121 | $874,121 |
| SEMINAR FEES/OTHER | 900099 | $25,270 | $25,270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $899,391 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,913 | TotalRevenueColumnAmt |
| Exclusion | $4,913 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,649,229 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $899,391 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,913 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,732 | TotalAmt |
| Program Services | $160,042 | ProgramServicesAmt |
| Management And General | $119,720 | ManagementAndGeneralAmt |
| Fundraising | $10,970 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,484,991 | TotalAmt |
| Program Services | $1,270,561 | ProgramServicesAmt |
| Management And General | $197,501 | ManagementAndGeneralAmt |
| Fundraising | $16,929 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,062 | TotalAmt |
| Program Services | $136,756 | ProgramServicesAmt |
| Management And General | $28,850 | ManagementAndGeneralAmt |
| Fundraising | $2,456 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,939 | TotalAmt |
| Program Services | $95,232 | ProgramServicesAmt |
| Management And General | $22,715 | ManagementAndGeneralAmt |
| Fundraising | $1,992 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,525 | TotalAmt |
| Management And General | $4,525 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,405 | TotalAmt |
| Management And General | $12,405 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,586 | TotalAmt |
| Program Services | $19,522 | ProgramServicesAmt |
| Management And General | $4,656 | ManagementAndGeneralAmt |
| Fundraising | $408 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,889 | TotalAmt |
| Program Services | $1,226 | ProgramServicesAmt |
| Fundraising | $11,663 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,682 | TotalAmt |
| Program Services | $18,998 | ProgramServicesAmt |
| Management And General | $14,290 | ManagementAndGeneralAmt |
| Fundraising | $394 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,306 | TotalAmt |
| Program Services | $32,555 | ProgramServicesAmt |
| Management And General | $56,751 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,766 | TotalAmt |
| Program Services | $133,515 | ProgramServicesAmt |
| Management And General | $15,217 | ManagementAndGeneralAmt |
| Fundraising | $3,034 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,064 | TotalAmt |
| Program Services | $4,735 | ProgramServicesAmt |
| Management And General | $1,329 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,254 | TotalAmt |
| Program Services | $19,533 | ProgramServicesAmt |
| Management And General | $3,721 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,490 | TotalAmt |
| Program Services | $18,245 | ProgramServicesAmt |
| Management And General | $18,245 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,632 | TotalAmt |
| Program Services | $30,674 | ProgramServicesAmt |
| Management And General | $7,316 | ManagementAndGeneralAmt |
| Fundraising | $642 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM EXPENSES | $17,414 | $17,414 | |
| BAD DEBTS | $16,921 | $16,921 | |
| DUES | $12,785 | $12,785 | |
| MISCELLANEOUS | $6,064 | $6,064 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,550,507 | TotalAmt |
| Program Services | $1,988,714 | ProgramServicesAmt |
| Management And General | $513,305 | ManagementAndGeneralAmt |
| Fundraising | $48,488 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,480 | BOYAmt |
| EOY | $307,022 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $8,500 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,002 | BOYAmt |
| EOY | $81,014 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,240 | BOYAmt |
| EOY | $28,230 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $480,587 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $430,386 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,165 | BOYAmt |
| EOY | $50,201 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,824 | BOYAmt |
| EOY | $415,338 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $392,315 | BOYAmt |
| EOY | $375,493 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,282,026 | BOYAmt |
| EOY | $1,265,798 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,445 | BOYAmt |
| EOY | $231,421 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,620 | BOYAmt |
| EOY | $1,218,495 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,121,065 | BOYAmt |
| EOY | $1,449,916 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$241,354 | BOYAmt |
| EOY | -$567,611 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,315 | BOYAmt |
| EOY | $383,493 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,961 | BOYAmt |
| EOY | -$184,118 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,282,026 | BOYAmt |
| EOY | $1,265,798 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $98,722 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$21,042 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$422,759 | OtherChangesInNetAssetsAmt |
| 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 | 0 | FederalGrantAuditRequiredInd |
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 | $1,691,927 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,598,888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,545,598 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,728,767 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,744,925 | CurrentTaxYearAmt |
| Total | $8,310,105 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,691,927 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,598,888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,545,598 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,728,767 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,744,925 | CurrentTaxYearAmt |
| Total | $8,310,105 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,311,486 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,998,619 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,873 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,837 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,844 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,978 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,913 | CurrentTaxYearAmt |
| Total | $23,445 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $63,750 | CurrentTaxYearMinus2YearsAmt |
| Total | $63,750 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,397,300 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,310,777 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.71440 | PublicSupportCY170Pct |
| Public Support PY170 | 0.29400 | 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 | MEANINGFUL USE CREDIT | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $392,323 | BeginningYearBalanceAmt |
| Contributions | $10,070 | ContributionsAmt |
| Investment Earnings Or Losses | -$7,404 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $16,341 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $3,150 | AdministrativeExpensesAmt |
| End Year Balance | $375,493 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $364,309 | BeginningYearBalanceAmt |
| Contributions | $32,150 | ContributionsAmt |
| Investment Earnings Or Losses | $13,093 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $14,434 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $2,795 | AdministrativeExpensesAmt |
| End Year Balance | $392,323 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $286,729 | BeginningYearBalanceAmt |
| Contributions | $39,775 | ContributionsAmt |
| Investment Earnings Or Losses | $53,093 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $13,135 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $2,153 | AdministrativeExpensesAmt |
| End Year Balance | $364,309 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $230,151 | BeginningYearBalanceAmt |
| Contributions | $40,538 | ContributionsAmt |
| Investment Earnings Or Losses | $44,750 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $26,082 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $2,628 | AdministrativeExpensesAmt |
| End Year Balance | $286,729 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $215,675 | BeginningYearBalanceAmt |
| Contributions | $18,747 | ContributionsAmt |
| Investment Earnings Or Losses | -$3,814 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $457 | AdministrativeExpensesAmt |
| End Year Balance | $230,151 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,854 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,854 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $399,327 | OtherCostOrOtherBasisAmt |
| Depreciation | $351,833 | DepreciationAmt |
| Book Value | $47,494 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,406 | OtherCostOrOtherBasisAmt |
| Depreciation | $62,699 | DepreciationAmt |
| Book Value | $2,707 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $50,201 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CERTIFICATES OF DEPOSIT | $350,033 | F |
| CERTIFICATES OF DEPOSIT - DEFERRED COMP | $65,305 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $415,338 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FUNDS HELD BY THE SAINT PAUL FOUNDATION | Desc |
| Book Value | $375,493 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $375,493 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LIABILITY FOR PENSION BENEFITS | $1,213,280 |
| LIABILITY FOR CAPITAL LEASE | $5,215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,218,495 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,601,295 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$21,042 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$26,892 | OtherRevenueAmt |
| Revenue Not Reported | -$47,934 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,649,229 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,649,229 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,550,507 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,550,507 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,550,507 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO PROVIDE SUPPORT TO ACCOMPLISH THE ORGANIZATION'S EXEMPT PURPOSE. |
| PART X, LINE 2: | THE CLINIC HAS BEEN CLASSIFIED AS A PUBLICLY SUPPORTED CLINIC, AND IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CLINIC HAS ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION OF UNCERTAIN TAX POSITIONS. THE GUIDANCE PRESCRIBES RECOGNITION THRESHOLD PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX FILING THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THIS GUIDANCE HAD NO IMPACT ON THE CLINIC'S FINANCIAL STATEMENTS. THE CLINIC'S TAX FILINGS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE CLINIC IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. THE CLINIC IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME, EXCISE OR OTHER TAXES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN VALUE - COMMUNITY FOUNDATION FUNDS -26,892. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE HAMM CLINIC EXECUTIVE COMMITTEE IS COMPRISED OF THE BOARD OF OFFICERS (PRESIDENT, VICE PRESIDENT, TREASURER AND SECRETARY); THE ASSISTANT SECRETARY; THE COMMITTEE CHAIRPERSONS; THE EXECUTIVE MEDICAL DIRECTOR AND THE CHIEF OPERATING OFFICER; AND ANY OTHER BOARD MEMBER THE PRESIDENT APPOINTS TO THE EXECUTIVE COMMITTEE. AD HOC RESPONSIBILITIES (PERFORMED ON AN AS NEEDED BASIS): - ADVISE EXECUTIVE MEDICAL DIRECTOR AND CHIEF OPERATING OFFICER ON PERSONNEL MATTERS, AS REQUESTED. - CONDUCT THE BUSINESS FOR THE BOARD, IF NECESSARY BEFORE THE FULL BOARD CAN MEET. - IMPLEMENT PROCESS AND PROCEDURES FOR SELECTION OF A NEW EXECUTIVE MEDICAL DIRECTOR AND THE CHIEF OPERATING OFFICER. - MONITOR THE PERFORMANCE OF THE BOARD COMMITTEES. TAKE ACTION TO CORRECT ANY DEFICIENCIES. - REVIEW OPERATIONAL RESULTS AND STATISTICS. - REVIEW INFORMATION ABOUT EXTERNAL TRENDS AND DEVELOPMENTS. |
| FORM 990, PART VI, SECTION A, LINE 2 | EDWARD H. HAMM AND EDWARD H. HAMM III, BOTH BOARD MEMBERS, HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FINANCE COMMITTEE WILL MEET WITH THE AUDITORS ON OR BEFORE SEPTEMBER 16TH TO REVIEW THE AUDIT RESULTS AND FINANCIAL REPORTS. THE FORM 990 WILL BE EMAILED TO ALL FINANCE COMMITTEE MEMBERS FOR THEIR REVIEW AND EDIT COMMENTS. THE CONTROLLER AND COO WILL ALSO REVIEW THE FORM 990. A COPY OF THE FORM 990 WILL BE PROVIDED TO THE WHOLE BOARD BEFORE IT IS FILED WITH IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS FILL OUT AN ANNUAL DISCLOSURE FORM. IN THE CASE OF A CONFLICT, OR THE APPEARANCE THEREOF, BOARD MEMBERS ARE EXPECTED TO DISCLOSE THE CONFLICT PRIOR TO THE CLINIC'S MAKING ANY RELATED DECISIONS. IF A CONFLICT OF INTEREST IS PRESENT, THE DIRECTOR INVOLVED MUST IDENTIFY THE CONFLICT AND MAY, AT THE REQUEST OF THE BOARD OR COMMITTEE, REMAIN IN THE ROOM TO ANSWER QUESTIONS OF A FACTUAL NATURE THAT MAY ASSIST THE BOARD OR COMMITTEE IN ITS DELIBERATION AND DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT OF INTEREST EXISTS. BOARD MEMBERS HAVING A CONFLICT OF INTEREST ON A GIVEN ISSUE DO NOT VOTE ON THAT ISSUE. PROCEEDINGS RELATED TO CONFLICTS OF INTEREST ARE DOCUMENTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF OPERATING OFFICER INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION. THE EXECUTIVE COMMITTEE ALSO REVIEWS THE COMPENSATION AND BONUS PLAN. THE PROCESS WAS LAST UNDERTAKEN FOR THE CHIEF OPERATING OFFICER, S. DWYER IN 2015 THE PROCESS FOR DETERMINING OTHER OFFICERS' COMPENSATION INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, CONTEMPORANEOUS SUBSTANTIATION, AND A REVIEW BY THE EXECUTIVE AND FINANCE COMMITTEES WITH THE CHIEF OPERATING OFFICER AND THE BOARD PRESIDENT. THE PROCESS WAS LAST UNDERTAKEN FOR THE CONTROLLER, R. BOURMAN IN 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CLINIC'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE - COMMUNITY FOUNDATION FUNDS -26,892. CHANGE IN LONG-TERM PENSION OBLIGATION -395,867. |