DFD RUSSELL MEDICAL CENTER INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- DFD RUSSELL MEDICAL CENTER INC (EIN 23-7423047)
- Tax period
- 2024-04-01 to 2025-03-31
- Filed
- 2026-01-07
- IRS object ID
- 202600139349303155
- Schema version
- 2024v5.0
- 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 | 2026-01-07T10:19:46-05:00 | ReturnTs |
| Tax Period End | 2025-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010440155 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUNYON KERSTEEN OUELLETTE | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 LONG CREEK DR | AddressLine1Txt |
| City | SOUTH PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04106 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237423047 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DFD RUSSELL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DFDR | BusinessNameControlTxt |
| Phone | 2075243501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 CHURCH HILL ROAD | AddressLine1Txt |
| City | LEEDS | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04263 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELE TANGUAY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2075244004 | PhoneNum |
| Signature | 2026-01-06 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY CHASSE | PreparerPersonNm |
| PTIN | P00967183 | PTIN |
| Phone | 2077732986 | PhoneNum |
| Preparation | 2026-01-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LAURIE KANE-LEWIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 CHURCH HILL ROAD | AddressLine1Txt |
| City | LEEDS | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04263 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,792,851 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DFDRUSSELL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF DFD RUSSELL MEDICAL CENTER IS TO ENSURE THAT EVERYONE IN OUR COMMUNITIES HAVE ACCESS TO, AND ARE PROVIDED WITH, THE HIGHEST QUALITY PRIMARY HEALTH CARE, REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 130 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,442,723 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,375,939 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,998,196 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,401,045 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,302 | PYInvestmentIncomeAmt |
| CY Investment Income | $12,342 | CYInvestmentIncomeAmt |
| PY Other Revenue | $604 | PYOtherRevenueAmt |
| CY Other Revenue | $3,525 | CYOtherRevenueAmt |
| PY Total Revenue | $10,453,825 | PYTotalRevenueAmt |
| CY Total Revenue | $10,792,851 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,050,081 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,181,560 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,450,196 | PYOtherExpensesAmt |
| CY Other Expenses | $2,766,569 | CYOtherExpensesAmt |
| PY Total Expenses | $10,500,277 | PYTotalExpensesAmt |
| CY Total Expenses | $10,948,129 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$46,452 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$155,278 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,000,266 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,734,662 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,254,346 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,148,173 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,745,920 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,586,489 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF DFD RUSSELL MEDICAL CENTER IS TO ENSURE THAT EVERYONE IN OUR COMMUNITIES HAVE ACCESS TO, AND ARE PROVIDED WITH, THE HIGHEST QUALITY PRIMARY HEALTH CARE, REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,378,976 | ExpenseAmt |
| Revenue | $8,401,045 | RevenueAmt |
| Desc | DFD RUSSELL MEDICAL CENTER (DFD RMC) IS A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER. AS SUCH IT PROVIDES A RANGE OF SERVICES FOR RESIDENTS OF WESTERN AND CENTRAL MAINE FROM SITES IN THE TOWNS OF LEEDS, MONMOUTH, BRIDGTON, AND TURNER. DURING THE TAX YEAR, DFD RMC PROVIDED 26,849 MEDICAL ENCOUNTERS, 4,951 BEHAVIORAL HEALTH ENCOUNTERS, AND 59 DENTAL HYGIENE ENCOUNTERS TO A TOTAL OF 9,060 MEDICAL PATIENTS, 914 BEHAVIORAL HEALTH PATIENTS, AND 56 DENTAL HYGIENE PATIENTS. 30% OF THESE PATIENTS HAD INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINE. | Desc |
| Total Program Service Expenses | $8,378,976 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 130 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELE TANGUAY | PersonNm |
| Phone | 2075244004 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 CHURCH HILL ROAD SUITE 1 | AddressLine1Txt |
| City | LEEDS | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04263 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| THERESA GILLIS | ||||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL EATON | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DALE HINDS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY DOUGHERTY | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WES WISSE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL LEE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LAURIE KANE-LEWIS | ||||||||
| CEO | 40.00 | Yes (X) | $223,614 | $0 | $29,368 | |||
| MICHELE TANGUAY | ||||||||
| CFO | 40.00 | Yes (X) | $102,061 | $0 | $19,710 | |||
| GARY RIVARD DO | ||||||||
| MEDICAL DIRE | 40.00 | $314,051 | $0 | $45,674 | Yes (X) | |||
| LESLIE BRADBURY | ||||||||
| PHYSICIAN | 40.00 | $250,121 | $0 | $28,033 | Yes (X) | |||
| CHRISTOPHER BUTLER | ||||||||
| NURSE PRACTI | 40.00 | $124,041 | $0 | $36,807 | Yes (X) | |||
| HEATHER ERRINGTON | ||||||||
| NURSE PRACTI | 40.00 | $122,910 | $0 | $27,499 | Yes (X) | |||
| TRISHA GUSHUE | ||||||||
| PHYSICIAN | 40.00 | $252,466 | $0 | $33,051 | Yes (X) | |||
| LAURIE HUNTRESS | ||||||||
| PHYSICIAN | 40.00 | $255,007 | $0 | $43,389 | Yes (X) | |||
| JENNIFER MICHAUD | ||||||||
| NURSE PRACTI | 40.00 | $122,378 | $0 | $15,566 | Yes (X) | |||
| STEPHANIE PRATT | ||||||||
| COORDINATOR | 40.00 | $102,988 | $0 | $16,932 | Yes (X) | |||
| BRIDGET ROSS-FITZGIBBONS | ||||||||
| NURSE PRACTI | 40.00 | $123,335 | $0 | $15,628 | Yes (X) | |||
| KELLEY STANLEY | ||||||||
| PHYSICIAN | 40.00 | $251,808 | $0 | $43,260 | Yes (X) | |||
| LYDIA THORP | ||||||||
| PHYSICIAN | 40.00 | $266,847 | $0 | $43,799 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,511,627 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $398,716 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | H3C LLC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2909 N 118TH ST STE 120 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68164 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CCM | ServicesDesc |
| Compensation | $176,167 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,375,939 | GovernmentGrantsAmt |
| Total Contributions | $2,375,939 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 621110 | $6,605,265 | $6,605,265 |
| PHARMACY PROGRAM | 621110 | $1,380,226 | $1,380,226 |
| QUALITY INITIATIVES | 621110 | $415,554 | $415,554 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,401,045 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,342 | TotalRevenueColumnAmt |
| Exclusion | $12,342 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $3,525 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,525 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,525 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,792,851 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,404,570 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $12,342 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $939,998 | TotalAmt |
| Program Services | $225,868 | ProgramServicesAmt |
| Management And General | $714,130 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,654,186 | TotalAmt |
| Program Services | $5,335,436 | ProgramServicesAmt |
| Management And General | $318,750 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,282 | TotalAmt |
| Program Services | $155,993 | ProgramServicesAmt |
| Management And General | $5,289 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $945,666 | TotalAmt |
| Program Services | $853,791 | ProgramServicesAmt |
| Management And General | $91,875 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480,428 | TotalAmt |
| Program Services | $405,861 | ProgramServicesAmt |
| Management And General | $74,567 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,934 | TotalAmt |
| Management And General | $28,934 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,531 | TotalAmt |
| Management And General | $24,531 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,980 | TotalAmt |
| Program Services | $265,297 | ProgramServicesAmt |
| Management And General | $198,683 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,481 | TotalAmt |
| Management And General | $57,481 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,869 | TotalAmt |
| Program Services | $8,941 | ProgramServicesAmt |
| Management And General | $216,928 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,922 | TotalAmt |
| Program Services | $170,695 | ProgramServicesAmt |
| Management And General | $182,227 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,399 | TotalAmt |
| Management And General | $164,399 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,030 | TotalAmt |
| Management And General | $4,030 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,581 | TotalAmt |
| Program Services | $23,610 | ProgramServicesAmt |
| Management And General | $316,971 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,728 | TotalAmt |
| Management And General | $44,728 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| COST OF SALES - 340B PROG | $554,413 | $554,413 | |
| SUPPLIES | $226,198 | $188,976 | $37,222 |
| MAINTENANCE & REPAIRS | $74,697 | $4,700 | $69,997 |
| EDUCATION | $67,118 | $65,658 | $1,460 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,688 | TotalAmt |
| Program Services | $119,737 | ProgramServicesAmt |
| Management And General | $16,951 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,948,129 | TotalAmt |
| Program Services | $8,378,976 | ProgramServicesAmt |
| Management And General | $2,569,153 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,559 | BOYAmt |
| EOY | $20,169 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,065,174 | BOYAmt |
| EOY | $1,367,642 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $929,751 | BOYAmt |
| EOY | $685,828 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,853 | BOYAmt |
| EOY | $8,076 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $225,851 | BOYAmt |
| EOY | $255,918 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,660,315 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,484,750 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,375,818 | BOYAmt |
| EOY | $4,175,565 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,260 | BOYAmt |
| EOY | $221,464 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,000,266 | BOYAmt |
| EOY | $6,734,662 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $694,533 | BOYAmt |
| EOY | $776,921 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,184 | BOYAmt |
| EOY | $6,932 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,240,545 | BOYAmt |
| EOY | $2,170,726 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,084 | BOYAmt |
| EOY | $193,594 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,254,346 | BOYAmt |
| EOY | $3,148,173 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,745,920 | BOYAmt |
| EOY | $3,586,489 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,745,920 | BOYAmt |
| EOY | $3,586,489 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,000,266 | BOYAmt |
| EOY | $6,734,662 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$155,278 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,153 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,191,356 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,229,079 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,187,074 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,442,723 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,375,939 | CurrentTaxYearAmt |
| Total | $14,426,171 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,877,619 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,555,246 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,110,678 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,998,800 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,404,570 | CurrentTaxYearAmt |
| Total | $34,946,913 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,068,975 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,784,325 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,297,752 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,441,523 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,780,509 | CurrentTaxYearAmt |
| Total | $49,373,084 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,073,087 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,847,408 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,891,507 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,938,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,054,940 | CurrentTaxYearAmt |
| Total | $12,805,334 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,073,087 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,847,408 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,891,507 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,938,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,054,940 | CurrentTaxYearAmt |
| Total | $12,805,334 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $36,567,750 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,305 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,955 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,908 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,342 | CurrentTaxYearAmt |
| Total | $40,812 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,305 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,955 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,908 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,342 | CurrentTaxYearAmt |
| Total | $40,812 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,073,280 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,787,280 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,306,660 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,453,825 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,792,851 | CurrentTaxYearAmt |
| Total | $49,413,896 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.74000 | PublicSupportCY509Pct |
| Public Support PY509 | 0.72190 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $190,619 | OtherCostOrOtherBasisAmt |
| Book Value | $190,619 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,954,481 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,329,051 | DepreciationAmt |
| Book Value | $3,625,430 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,515,215 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,155,699 | DepreciationAmt |
| Book Value | $359,516 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,175,565 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT OF USE LIABILITY - OPERATING | Desc |
| Amt | $193,594 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $193,594 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,788,698 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$4,153 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$4,153 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,792,851 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $10,792,851 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,948,129 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $10,948,129 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $10,948,129 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE AND STATE TAXING AUTHORITIES. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| LAURIE KANE-LEWIS | ||||
| CEO | $223,614 | $9,079 | $20,289 | $252,982 |
| GARY RIVARD DO | ||||
| MEDICAL DIRECTOR | $314,051 | $12,595 | $33,079 | $359,725 |
| LESLIE BRADBURY | ||||
| PHYSICIAN | $250,121 | $8,890 | $19,143 | $278,154 |
| CHRISTOPHER BUTLER | ||||
| NURSE PRACTITIONER | $124,041 | $3,728 | $33,079 | $160,848 |
| HEATHER ERRINGTON | ||||
| NURSE PRACTITIONER | $122,910 | $4,554 | $22,945 | $150,409 |
| TRISHA GUSHUE | ||||
| PHYSICIAN | $252,466 | $10,106 | $22,945 | $285,517 |
| LAURIE HUNTRESS | ||||
| PHYSICIAN | $255,007 | $10,310 | $33,079 | $298,396 |
| KELLEY STANLEY | ||||
| PHYSICIAN | $251,808 | $10,181 | $33,079 | $295,068 |
| LYDIA THORP | ||||
| PHYSICIAN | $266,847 | $10,720 | $33,079 | $310,646 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PROVIDED TO THE FULL BOARD OF DIRECTORS BEFORE IT IS FILED AND IS REVIEWED BY THE FINANCE COMMITTEE PRIOR TO THAT MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | MEMBERS OF THE BOARD AND THE SENIOR MANAGEMENT MUST REVIEW THEIR INDIVIDUAL CONFLICT OF INTEREST DOCUMENT ON AN ANNUAL BASIS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION FOR THE CEO IS REVIEWED AND APPROVED BY THE FULL BOARD DURING AN EXECUTIVE SESSION. THE REVIEW INCLUDES COMPARATIVE DATA FOR BOTH THE REGION AND THE NATION FOR CEO'S IN ORGANIZATIONS OF SIMILAR PURPOSE, SCOPE, AND SIZE. THE MEETING IS DOCUMENTED IN MINUTES AND THE DECISION FORWARDED DIRECTLY BY THE PRESIDENT TO THE CHIEF FINANCIAL OFFICER FOR IMPLEMENTATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | NACHC AND OTHER HEALTH CENTERS ARE QUERIED FOR THE SALARIES OF THE CFO, DIRECTOR OF CLINICAL QUALITY, AND MEDICAL DIRECTOR. SALARIES ARE PAID BASED UPON THE PREVAILING MARKET FOR ALL CLINICIANS, AND SALARY SURVEYS (MGMA, MPCA, AND NACHC) ARE LOOKED AT AND RECRUITING FIRMS ARE USED AS A RESOURCE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |