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HAMM MEMORIAL PSYCHIATRIC CLINIC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
HAMM MEMORIAL PSYCHIATRIC CLINIC (EIN 41-1649502)
Tax period
2014-07-01 to 2015-06-30
Filed
2015-10-05
IRS object ID
201542789349300219
Schema version
2014v5.0
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

FieldValueIRS element (for citing)
Return2015-10-05T09:17:22-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411649502EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HAMM MEMORIAL PSYCHIATRIC CLINICBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHAMMBusinessNameControlTxt
Phone6512240614PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1408 ST PETER STREET NO 429AddressLine1Txt
CityST PAULCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55102ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEPHEN DWYERPersonNm
Person TitleCHIEF OPERATING OFFICERPersonTitleTxt
Phone6512240614PhoneNum
Signature2015-10-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY HENDLEYPreparerPersonNm
PTINP01300654PTIN
Phone6123764500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEPHEN DWYERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1408 ST PETER STREET NO 429AddressLine1Txt
CityST PAULCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55102ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,580,976GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HAMMCLINIC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee34TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,545,598PYContributionsGrantsAmt
CY Contributions Grants$1,728,767CYContributionsGrantsAmt
PY Program Service Revenue$875,937PYProgramServiceRevenueAmt
CY Program Service Revenue$840,852CYProgramServiceRevenueAmt
PY Investment Income$8,416PYInvestmentIncomeAmt
CY Investment Income$5,987CYInvestmentIncomeAmt
PY Other Revenue$63,750PYOtherRevenueAmt
CY Other Revenue-$14,660CYOtherRevenueAmt
PY Total Revenue$2,493,701PYTotalRevenueAmt
CY Total Revenue$2,560,946CYTotalRevenueAmt
PY Grants And Similar Paid$69,139PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,855,661PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,953,968CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$72,075CYTotalFundraisingExpenseAmt
PY Other Expenses$545,710PYOtherExpensesAmt
CY Other Expenses$469,903CYOtherExpensesAmt
PY Total Expenses$2,470,510PYTotalExpensesAmt
CY Total Expenses$2,433,871CYTotalExpensesAmt
PY Revenues Less Expenses$23,191PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$127,075CYRevenuesLessExpensesAmt
Total Assets BOY$1,278,646TotalAssetsBOYAmt
Total Assets EOY$1,282,026TotalAssetsEOYAmt
Total Liabilities BOY$692,327TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,121,065TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$586,319NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$160,961NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE QUALITY MENTAL HEALTH TREATMENT, REGARDLESS OF ABILITY TO PAY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,347,269ExpenseAmt
Revenue$810,689RevenueAmt
DescCLINICAL 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 FY15, 701 PATIENTS WERE SERVED TOTALING 8,701 VISITS TO THE CLINIC.ELECTRONIC HEALTH RECORDS (EHR) PROGRAM: THE CLINIC TRANSITIONED TO AN ELECTRONIC HEALTH RECORDS SYSTEM.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$308,695ExpenseAmt
Grant$10,000GrantAmt
Revenue$30,163RevenueAmt
DescTRAINING 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

FieldValueIRS element (for citing)
Expense$112,133ExpenseAmt
DescRESEARCH 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

FieldValueIRS element (for citing)
Expense$101,580ExpenseAmt
DescCOMMUNITY OUTREACH: THE CLINIC WORKS TO EDUCATE THE PUBLIC ABOUT MENTAL HEALTH ISSUES AND PROMOTES THE VALUE OF GOOD MENTAL HEALTH. IT ALSO WORKS TO BE A VOICE IN THE COMMUNITY FOR PERSONS WITH MENTAL ILLNESS AND TO IMPROVE PUBLIC AWARENESS OF THE SCOPE OF INFLUENCE ADULT MENTAL ILLNESS HAS ON THE COMMUNITY.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$101,580TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$1,869,677TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document13IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee34EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRICHARD BOURMAN CONTROLLERPersonNm
Phone6512240614PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1408 ST PETER STREET SUITE 429AddressLine1Txt
CityST PAULCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55102ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ROGER OPP
BOARD PRESIDENT3.00Yes (X)Yes (X)$0$0$0
ELIZABETH WITTENBERG
BOARD VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
ABBY DAWKINS
BOARD SECRETARY1.00Yes (X)Yes (X)$0$0$0
J LAWRENCE MCINTYRE
BOARD TREASURER3.00Yes (X)Yes (X)$0$0$0
HENRY STOCKMAN
BOARD MEMBER1.00Yes (X)$0$0$0
DINA RAUKER
BOARD MEMBER1.00Yes (X)$0$0$0
VICTORIA COIFMAN
BOARD MEMBER1.00Yes (X)$0$0$0
ANNE R GEARITY
BOARD MEMBER1.00Yes (X)$0$0$0
EDWARD H HAMM
BOARD MEMBER1.00Yes (X)$0$0$0
EDWARD H HAMM III
BOARD MEMBER1.00Yes (X)$0$0$0
JAMES F HART MD
BOARD MEMBER1.00Yes (X)$0$0$0
JEREMY T LANG
BOARD MEMBER1.00Yes (X)$0$0$0
MICKEY MULCAHY
BOARD MEMBER1.00Yes (X)$0$0$0
PAUL W MATTESSICH PHD
BOARD MEMBER1.00Yes (X)$0$0$0
JONATHAN H MORGAN
BOARD MEMBER1.00Yes (X)$0$0$0
KELLEY O'NEILL
BOARD MEMBER1.00Yes (X)$0$0$0
PAULA RICHEY
BOARD MEMBER1.00Yes (X)$0$0$0
KARI HUBBARD ROMINSKI
BOARD MEMBER1.00Yes (X)$0$0$0
MARK E SUNDBY PHD
BOARD MEMBER1.00Yes (X)$0$0$0
ROBERT NESHEIM MD
EXECUTIVE MEDICAL DIRECTOR32.00Yes (X)$142,465$0$15,000
STEPHEN DWYER
CHIEF OPERATING OFFICER40.00Yes (X)$101,901$0$12,000
RICHARD BOURMAN
CONTROLLER24.00Yes (X)$68,512$0$1,500
FieldValueIRS element (for citing)
Total Reportable Comp From Org$312,878TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$28,500TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$34,486FundraisingAmt
All Other Contributions$1,694,281AllOtherContributionsAmt
Noncash Contributions$54,570NoncashContributionsAmt
Total Contributions$1,728,767TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT FEES621400$810,689$810,689
SEMINAR FEES/OTHER900099$30,163$30,163
FieldValueIRS element (for citing)
Total Program Service Revenue$840,852TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,987TotalRevenueColumnAmt
Exclusion$5,987ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$5,370FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$34,486ContriRptFundraisingEventAmt
Fundraising Direct Expenses$20,030FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$14,660TotalRevenueColumnAmt
Exclusion-$14,660ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,560,946TotalRevenueColumnAmt
Related Or Exempt Func Income$840,852RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$8,673ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$10,000TotalAmt
Program Services$10,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$341,377TotalAmt
Program Services$212,671ProgramServicesAmt
Management And General$109,443ManagementAndGeneralAmt
Fundraising$19,263FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,307,294TotalAmt
Program Services$1,098,427ProgramServicesAmt
Management And General$183,334ManagementAndGeneralAmt
Fundraising$25,533FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$201,292TotalAmt
Program Services$160,645ProgramServicesAmt
Management And General$36,168ManagementAndGeneralAmt
Fundraising$4,479FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$104,005TotalAmt
Program Services$80,855ProgramServicesAmt
Management And General$20,134ManagementAndGeneralAmt
Fundraising$3,016FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,570TotalAmt
Management And General$6,570ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$13,331TotalAmt
Management And General$13,331ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$20,618TotalAmt
Program Services$10,038ProgramServicesAmt
Management And General$10,580ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$17,899TotalAmt
Program Services$453ProgramServicesAmt
Fundraising$17,446FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$33,904TotalAmt
Program Services$20,659ProgramServicesAmt
Management And General$13,245ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$72,378TotalAmt
Program Services$32,599ProgramServicesAmt
Management And General$39,779ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$150,997TotalAmt
Program Services$133,449ProgramServicesAmt
Management And General$15,210ManagementAndGeneralAmt
Fundraising$2,338FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,601TotalAmt
Program Services$5,107ProgramServicesAmt
Management And General$3,494ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$28,581TotalAmt
Program Services$24,827ProgramServicesAmt
Management And General$3,754ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$41,746TotalAmt
Program Services$20,873ProgramServicesAmt
Management And General$20,873ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$42,373TotalAmt
Program Services$33,925ProgramServicesAmt
Management And General$8,448ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DUES$12,989$12,989
BAD DEBTS$10,868$10,868
MISCELLANEOUS$6,368$321$6,047
EQUIPMENT MAINTENANCE$1,709$1,709

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$971TotalAmt
Program Services$971ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,433,871TotalAmt
Program Services$1,869,677ProgramServicesAmt
Management And General$492,119ManagementAndGeneralAmt
Fundraising$72,075FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$272,461BOYAmt
EOY$243,480EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,169BOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$42,000BOYAmt
EOY$10,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$62,617BOYAmt
EOY$64,002EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$30,798BOYAmt
EOY$24,240EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$459,061LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$393,896LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$106,849BOYAmt
EOY$65,165EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$396,444BOYAmt
EOY$482,824EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$364,308BOYAmt
EOY$392,315EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,278,646BOYAmt
EOY$1,282,026EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$249,196BOYAmt
EOY$253,445EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$443,131BOYAmt
EOY$867,620EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$692,327BOYAmt
EOY$1,121,065EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$180,011BOYAmt
EOY-$241,354EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$406,308BOYAmt
EOY$402,315EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$586,319BOYAmt
EOY$160,961EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,278,646BOYAmt
EOY$1,282,026EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$127,075ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$13,407NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$539,026OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,610,996CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,691,927CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,598,888CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,545,598CurrentTaxYearMinus1YearAmt
Current Tax Year$1,728,767CurrentTaxYearAmt
Total$8,176,176TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,610,996CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,691,927CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,598,888CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,545,598CurrentTaxYearMinus1YearAmt
Current Tax Year$1,728,767CurrentTaxYearAmt
Total$8,176,176TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$5,744,109SubstantialContributorsTotAmt
Public Support Total170$2,432,067PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,352CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,873CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,837CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,844CurrentTaxYearMinus1YearAmt
Current Tax Year$5,978CurrentTaxYearAmt
Total$32,884TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$63,750CurrentTaxYearMinus1YearAmt
Total$63,750TotalAmt
FieldValueIRS element (for citing)
Total Support$8,272,810TotalSupportAmt
Gross Receipts Rltd Activities$4,269,373GrossReceiptsRltdActivitiesAmt
Public Support CY1700.29400PublicSupportCY170Pct
Public Support PY1700.30580PublicSupportPY170Pct
Ten Pct Facts Crcmstncs Test CYYes (X)TenPctFactsCrcmstncsTestCYInd
Facts And Circumstances TestSCHEDULE A, PART II, LINE 17A, EXPLANATION FOR FACTS AND CIRCUMSTANCES TESTTHE CLINIC MAINTAINS ACTIVE COMMUNITY SUPPORT WHICH HAS SUCCESSFULLY ATTRACTED CONTRIBUTIONS FROM THE GENERAL PUBLIC. THEIR ANNUAL FUNDRAISING EFFORTS PROVIDE AN OPPORTUNITY FOR THE GENERAL PUBLIC TO KNOW MORE ABOUT THE ORGANZATION AND TO SUPPORT THE CLINIC'S PROGRAMS. THE CLINIC'S BOARD OF DIRECTORS REPRESENTS LEADERSHIP FROM AND OF THE COMMUNITY, AS WELL AS NONPROFIT MANAGEMENT EXPERTISE. THE BOARD HAS BEEN DESIGNED BOTH TO FACILIATE INVOLVEMENT BY FUNDERS AND TO ENSURE ACCOUNTABILITY TO THE BROAD COMMUNITY THE CLINIC SERVES. THE CLINIC HAS MANY PROGRAMS, COLLABORATIONS, AND RESOURCES AVAILABLE BOTH ON-SITE AND OFF-SITE THAT PROVIDE THE PUBLIC AND COMMUNITY WITH MENTAL HEALTH AND RELATED SERVICES.FactsAndCircumstancesTestTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$364,309BeginningYearBalanceAmt
Contributions$32,150ContributionsAmt
Investment Earnings Or Losses$13,093InvestmentEarningsOrLossesAmt
Grants Or Scholarships$14,434GrantsOrScholarshipsAmt
Administrative Expenses$2,795AdministrativeExpensesAmt
End Year Balance$392,323EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$286,729BeginningYearBalanceAmt
Contributions$39,775ContributionsAmt
Investment Earnings Or Losses$53,093InvestmentEarningsOrLossesAmt
Grants Or Scholarships$13,135GrantsOrScholarshipsAmt
Administrative Expenses$2,153AdministrativeExpensesAmt
End Year Balance$364,309EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$230,151BeginningYearBalanceAmt
Contributions$40,538ContributionsAmt
Investment Earnings Or Losses$44,750InvestmentEarningsOrLossesAmt
Grants Or Scholarships$26,082GrantsOrScholarshipsAmt
Administrative Expenses$2,628AdministrativeExpensesAmt
End Year Balance$286,729EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$215,675BeginningYearBalanceAmt
Contributions$18,747ContributionsAmt
Investment Earnings Or Losses-$3,814InvestmentEarningsOrLossesAmt
Administrative Expenses$457AdministrativeExpensesAmt
End Year Balance$230,151EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,854OtherCostOrOtherBasisAmt
Depreciation$15,854DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$377,801OtherCostOrOtherBasisAmt
Depreciation$323,529DepreciationAmt
Book Value$54,272BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,406OtherCostOrOtherBasisAmt
Depreciation$54,513DepreciationAmt
Book Value$10,893BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$65,165TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
CERTIFICATES OF DEPOSIT$399,928F
CERTIFICATES OF DEPOSIT - DEFERRED COMP$82,896F
FieldValueIRS element (for citing)
Total Book Value Securities$482,824TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescFUNDS HELD BY THE SAINT PAUL FOUNDATIONDesc
Book Value$392,315BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$392,315TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
LIABILITY FOR PENSION BENEFITS$860,386
LIABILITY FOR CAPITAL LEASE$7,234
FieldValueIRS element (for citing)
Total Liability$867,620TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$2,563,426TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$13,407NetUnrealizedGainsInvstAmt
Other Revenue$15,887OtherRevenueAmt
Revenue Not Reported$2,480RevenueNotReportedAmt
Revenue Subtotal$2,560,946RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,560,946TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,453,901TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$20,030OtherExpensesIncludedAmt
Expenses Not Reported$20,030ExpensesNotReportedAmt
Expenses Subtotal$2,433,871ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,433,871TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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. THE FILINGS FOR THE YEARS 2010 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN VALUE - COMMUNITY FOUNDATION FUNDS -4,143. SPECIAL EVENT EXPENSES 20,030.
PART XII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENT EXPENSES 20,030.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event160TH ANNIVERSARY CELEBRATIONEvent1Nm
Gross Receipts Event1$39,856GrossReceiptsEvent1Amt
Charitable Contri Event1$34,486CharitableContriEvent1Amt
Gross Revenue Event1$5,370GrossRevenueEvent1Amt
Rent Facility Costs Event1$700RentFacilityCostsEvent1Amt
Food And Beverage Event1$8,621FoodAndBeverageEvent1Amt
Entertainment Event1$1,500EntertainmentEvent1Amt
Other Direct Expenses Event1$9,209OtherDirectExpensesEvent1Amt
Gross Receipts Total$39,856GrossReceiptsTotalAmt
Charitable Contributions Tot$34,486CharitableContributionsTotAmt
Gross Revenue Total Events$5,370GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$700RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$8,621FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,500EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$9,209OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$20,030DirectExpenseSummaryEventsAmt
Net Income Summary-$14,660NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeGRANTS, IN THE FORM OF STIPENDS, ARE GIVEN TO PSYCHOLOGY STUDENTS IN BI-WEEKLY PAYMENTS OVER A PERIOD OF ONE YEAR.GrantTypeTxt
Recipient2RecipientCnt
Cash Grant$10,000CashGrantAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationGRANTS, IN THE FORM OF STIPENDS, ARE GIVEN TO PSYCHOLOGY STUDENTS IN BI-WEEKLY PAYMENTS OVER A PERIOD OF ONE YEAR. THE CLINIC HAS THREE TYPES OF STUDENT PLACEMENTS: MASTERS LEVEL SOCIAL WORK STUDENTS, POST-GRADUATE PSYCHOLOGY STUDENTS AND POST DOCTORAL FELLOWS. EACH YEAR THE CLINIC DECIDES HOW MANY OF WHICH TYPE OF STUDENT THAT WILL BE ADMITTED. AFTER DETERMINATIONS ARE MADE, THE CLINIC NOTIFIES THE LOCAL SCHOOLS WITH WHOM THE CLINIC HAS AN ONGOING WORKING RELATIONSHIP WITH AND THE AMERICAN PSYCHOLOGICAL ASSOCIATION. THE LOCAL SCHOOLS ADVERTISE THE SOCIAL WORK AND POST-DOCTORAL OPENINGS AND THE AMERICAN PSYCHOLOGICAL ASSOCIATION ADVERTISES THE POST-GRADUATE PSYCHOLOGY POSITIONS. APPLICANTS WHO ARE VETTED BY THEIR RESPECTIVE ORGANIZATIONS ARE ELIGIBLE TO APPLY FOR A STUDENT PLACEMENT. THE CLINIC REVIEWS ALL APPLICATIONS AND THEN ARRANGE INTERVIEWS. A STAFF COMMITTEE MAKES THE ULTIMATE DECISION WHO TO ADMIT.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonROBERT NESHEIM MDPersonNm
TitleEXECUTIVE MEDICAL DIRECTORTitleTxt
Base Compensation Filing Org$142,465BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$15,000NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$157,465TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$54,570NoncashContributionsRptF990Amt
Method Of Determining RevenuesSTOCK MARKET QUOTESMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE CLINIC REPORTS THE NUMBER OF CONTRIBUTORS ON PART I, COLUMN B.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE 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 2EDWARD H. HAMM AND EDWARD H. HAMM III, BOTH BOARD MEMBERS, HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11THE FINANCE COMMITTEE WILL MEET WITH THE AUDITORS ON OR BEFORE SEPTEMBER 10TH 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 12CBOARD 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 15THE 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 EXECUTIVE MEDICAL DIRECTOR, DR. R. NESHEIM, AND CHIEF OPERATING OFFICER, S. DWYER IN 2013. 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 2012; AND MEDICAL DIRECTOR, R. NESHEIM IN 2012.
FORM 990, PART VI, SECTION C, LINE 19THE 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 -4,143. CHANGE IN LONG-TERM PENSION OBLIGATION -534,883.