NCH HEALTHCARE SYSTEMS INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- NCH HEALTHCARE SYSTEMS INC (EIN 59-2314655)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-09
- IRS object ID
- 201222229349300407
- Schema version
- 2010v3.7
- 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) |
|---|---|---|
| Timestamp | 2012-08-09T07:48:45-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET ST SUITE 1700 | AddressLine1 |
| City | PHILADELPHIA | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592314655 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NCH Healthcare System Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NCHH | NameControl |
| Phone | 2395137630 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 413029 | AddressLine1 |
| City | NAPLES | City |
| State | FL | State |
| ZIP Code | 341013029 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VICKI ORR | Name |
| Title | CFO | Title |
| Date Signed | 2012-08-03 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2673303000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | VICKI D ORR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 413029 | AddressLine1 |
| City | NAPLES | City |
| State | FL | State |
| ZIP Code | 341013029 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1086112 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.nchmd.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | THROUGH THE PROVISION OF CHARITABLE HEALTHCARE, OUR MISSION IS TO PROMOTE, MAINTAIN AND RESTORE HEALTH FOR THOSE WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 11 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 98390 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 72694 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1294679 | InvestmentIncomePriorYear |
| Investment Income Current Year | -758160 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 503850 | OtherRevenuePriorYear |
| Other Revenue Current Year | 607936 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | -790829 | TotalRevenuePriorYear |
| Total Revenue Current Year | -150213 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 988954 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1034705 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 1143377 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3699229 | OtherExpensePriorYear |
| Other Expenses Current Year | 1194304 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4688183 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2229009 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -5479012 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2379222 | RevenuesLessExpensesCY |
| Total Assets BOY | 20023554 | TotalAssetsBOY |
| Total Assets EOY | 20358304 | TotalAssetsEOY |
| Total Liabilities BOY | 10886689 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9426285 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9136865 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10932019 | NetAssetsOrFundBalancesEOY |
| Mission Description | THROUGH THE PROVISION OF CHARITABLE HEALTHCARE, OUR MISSION IS TO PROMOTE, MAINTAIN AND RESTORE HEALTH FOR THOSE WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | -573 | Expense |
| Grants | 0 | Grants |
| Revenue | 381 | Revenue |
| Description | NCH HEALTHCARE SYSTEM, INC.'S ("NHSI"), PRIMARY EXEMPT PURPOSE IS THE PROVISION OF CHARITABLE HEALTHCARE SERVICES. NHSI SERVES AS THE PARENT ORGANIZATION OF A NUMBER OF NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS AND OF A SUBSIDIARY WHOSE ACTIVITIES ARE CLASSIFIED AS FOR PROFIT. NHSI ACTS AS THE FUNDRAISING ARM FOR THE TAX-EXEMPT SERVICES PROVIDED BY THE NHSI ORGANIZATIONS IN THE COMMUNITY. ALL PROCEEDS FROM THE OPERATIONS OF THESE ORGANIZATIONS ARE USED TO REPLACE OR IMPROVE CURRENT HEALTHCARE TECHNOLOGY AND IMPROVE ACCESS TO NEEDED HEALTHCARE SERVICES IN OUR COMMUNITY, MUCH OF WHICH IS DELIVERED AT NO COST TO THOSE WHO DO NOT QUALIFY FOR EITHER GOVERNMENTAL OR PRIVATE INSURANCE AND ARE UNABLE TO PAY. ALSO SEE ATTACHED VALUING CHARITABLE HEALTH SERVICE REPORT. | Description |
| Total Program Service Expense | -573 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 32 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 11 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | FL | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | VICKI ORR CFOASST TREASURER | NamePerson |
| Telephone Number | 2395137630 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 7TH STREET NORTH | AddressLine1 |
| City | NAPLES | City |
| State | FL | State |
| ZIP Code | 341023029 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (42 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Allen S Weiss MD | ||||||
| President/CEO/Trustee | 1.0 | X | X | 0 | 643511 | 55504 |
| Terrance Flynn | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Kenneth Bookman MD | ||||||
| Trustee | 0.5 | X | 0 | 144916 | 8879 | |
| Joann Jenner | ||||||
| Trustee | 0.5 | X | 0 | 77422 | 18575 | |
| Frank Linsalata | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Robert Moses | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Gregory Wilkerson RN | ||||||
| Trustee | 0.5 | X | 0 | 64057 | 10986 | |
| Joseph I Perkovich | ||||||
| Chairman | 0.5 | X | X | 0 | 0 | 0 |
| Mariann MacDonald | ||||||
| 1st Vice Chairman | 0.5 | X | X | 0 | 0 | 0 |
| Ambassador Francis Rooney | ||||||
| Vice Chairman | 0.5 | X | X | 0 | 0 | 0 |
| Thomas J Gazdic | ||||||
| Secretary/Treasurer | 0.5 | X | X | 0 | 0 | 0 |
| William Allyn | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Jay H Baker | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Susan L Dalton | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Paul Dernbach MD | ||||||
| Trustee | 0.5 | X | 0 | 85500 | 0 | |
| Alberto M de la Rivaherrera MD | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Michael Feuer | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Daniel Gill | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Kay Gow | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Amy Jewell RN | ||||||
| Trustee | 0.5 | X | 0 | 30423 | 6972 | |
| Kim Ciccarelli Kantor | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Hermes Koop MD | ||||||
| Trustee | 0.5 | X | 0 | 5250 | 0 | |
| John Lewis MD | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Admiral Paul D Miller | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Wayne Mullican | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Karli Sander | ||||||
| Trustee | 0.5 | X | 0 | 48284 | 1912 | |
| Scot C Schultz MD | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Norman Thomson MD | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Carl E Westman | ||||||
| Trustee | 0.5 | X | 0 | 0 | 0 | |
| Kevin D Cooper | ||||||
| General Counsel/Chief of Staff | 1.0 | X | 0 | 374799 | 18113 | |
| Phillip Dutcher | ||||||
| COO, NCH Healthcare System | 1.0 | X | 0 | 376608 | 10431 | |
| Aurora Estevez MD | ||||||
| Chief Medical Officer | 1.0 | X | 0 | 394146 | 18216 | |
| Vicki D Orr | ||||||
| CFO/Assistant Treasurer | 1.0 | X | 0 | 369494 | 31028 | |
| BRIAN SETTLE TERM 93011 | ||||||
| Chief Human Resources Officer | 1.0 | X | 0 | 254326 | 23972 | |
| SUSAN WOLFF TERM 93011 | ||||||
| Chief Information Officer | 1.0 | X | 0 | 261411 | 17919 | |
| Michele Thoman | ||||||
| CNO | 1.0 | X | 0 | 242658 | 22465 | |
| Michael Riley | ||||||
| Chief Strategy Officer | 1.0 | X | 0 | 189961 | 29055 | |
| James K Martin | ||||||
| Chief Develop Officer | 40.0 | X | 298520 | 0 | 13603 | |
| William Edwards Term 06411 | ||||||
| Chief Administrative Officer | 1.0 | X | 0 | 107111 | 6012 | |
| Zach Bostock Start 091911 | ||||||
| Chief Administrative Officer | 1.0 | X | 0 | 0 | 0 | |
| Gary Parsons MD | ||||||
| Chief Medical Officer | 1.0 | X | 0 | 153351 | 3326 | |
| Elizabeth Martin | ||||||
| Assistant Secretary | 1.0 | X | 0 | 59103 | 14080 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 298520 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3882331 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 311048 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WICKERSMITHOHARAMCCOYGRAHAMFOR | |||||
| 2800 Ponce De Leon Boulevard Suite | CORAL GABLES | FL | 33134 | LEGAL SERVICES | 1022806 |
| DELOITTE AND TOUCHE LLP | |||||
| PO Box 7247-6446 | PHILADELPHIA | PA | 191706446 | Accounting | 552277 |
| MCDERMOTT WILL AND EMERY LLP | |||||
| PO BOX 6043 | CHICAGO | IL | 606806043 | LEGAL | 533811 |
| DELOITTE FINANCIAL ADVISORY SERVICE | |||||
| PO BOX 2062 | CAROL STREAM | IL | 601322062 | ACCOUNTING | 502891 |
| ECG MANAGEMENT CONSULTANTS INC | |||||
| 1111 THIRD AVENUE SUITE 2700 | SEATTLE | WA | 981013201 | CONSULTING | 224317 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | EMPLOYEE SALES | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 11 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -755922 | TotalRevenueColumn |
| Exclusion | -$755,922 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1840179 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1232613 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 607566 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 607566 | TotalRevenueColumn |
| Unrelated Business Revenue | 98390 | UnrelatedBusinessRevenue |
| Exclusion | $509,176 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1474 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3712 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -2238 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2238 | TotalRevenueColumn |
| Exclusion | -$2,238 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SALES TAX | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 370 | TotalRevenueColumn |
| Related Or Exempt Function Income | 370 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 370 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -150213 | TotalRevenueColumn |
| Related Or Exempt Function Income | 381 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 98390 | UnrelatedBusinessRevenue |
| Exclusion | -$248,984 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 339014 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 118655 | ManagementAndGeneral |
| Fundraising | 220359 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 531739 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 21964 | ManagementAndGeneral |
| Fundraising | 509775 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27356 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 3745 | ManagementAndGeneral |
| Fundraising | 23611 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79629 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 9752 | ManagementAndGeneral |
| Fundraising | 69877 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56967 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 9159 | ManagementAndGeneral |
| Fundraising | 47808 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 193233 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 193233 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 423800 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 423800 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 149292 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 149292 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162361 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 74762 | ManagementAndGeneral |
| Fundraising | 87599 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76404 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 76404 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99881 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 99881 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64044 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 64000 | ManagementAndGeneral |
| Fundraising | 44 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4718 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 4718 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19238 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 15937 | ManagementAndGeneral |
| Fundraising | 3301 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1906 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1906 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BAD DEBT EXPENSE | Description |
| Total | -573 | Total |
| Program Services | -573 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2229009 | Total |
| Program Services | -573 | ProgramServices |
| Management And General | 1086205 | ManagementAndGeneral |
| Fundraising | 1143377 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38839 | BOY |
| EOY | 38217 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 839645 | BOY |
| EOY | 839645 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1016183 | BOY |
| EOY | 1015807 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21758314 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7782802 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14144376 | BOY |
| EOY | 13975512 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2307455 | BOY |
| EOY | 2803781 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1677056 | BOY |
| EOY | 1685342 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20023554 | BOY |
| EOY | 20358304 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1035542 | BOY |
| EOY | 145138 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9320000 | BOY |
| EOY | 8750000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 531147 | BOY |
| EOY | 531147 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10886689 | BOY |
| EOY | 9426285 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9136865 | BOY |
| EOY | 10932019 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9136865 | BOY |
| EOY | 10932019 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20023554 | BOY |
| EOY | 20358304 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2379222 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 4174376 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NAPLES COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 590694358 | EIN |
| Type Of Organization | 03 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $149,292 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 149292 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DETAIL OF LOBBYING EXPENSES | Identifier |
| Return Reference | FORM 990, SCHEDULE C, PART II-B | ReturnReference |
| Explanation | NCH HEALTHCARE SYSTEM, INC. RETAINED A LAW FIRM TO MONITOR PENDING LEGISLATION OF RELEVANCE TO THE HOSPITAL AND TO MEET WITH STATE LEGISLATIVE OFFICALS REGARDING THE NCH HEALTHCARE SYSTEM, INC.'S POSITION ON PROPOSED LEGISLATION AND ADMINISTRATIVE RULES. THE FIRM IS ALSO RETAINED TO MONITOR LOCAL DEVELOPMENTS AND TO MEET WITH LOCAL COMMUNITY AGENCIES AND PROVIDE ADVICE REGARDING HEALTHCARE AND WORK FORCE HOUSING INITIATIVES IN THE COMMUNITY. IN ADDITION, THE SYSTEM IS A MEMBER OF THE FLORIDA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE DUES THAT THE SYSTEM CONTRIBUTES IS CONSIDERED LOBBYING EXPENSES. THE LOBBYING EXPENSES REPORTED ARE FOR THE 2011 FISCAL YEAR. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6741915 | OtherCostOrOtherBasis |
| Book Value | 6741915 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11860028 | OtherCostOrOtherBasis |
| Depreciation | 4917681 | Depreciation |
| Book Value | 6942347 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3156371 | OtherCostOrOtherBasis |
| Depreciation | 2865121 | Depreciation |
| Book Value | 291250 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 13975512 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM RELATED ORGANIZATIONS | 923857 |
| ASSETS LIMITED AS TO USE | 607145 |
| UNAMORTIZED BOND ISSUE COSTS | 123331 |
| SODEXHO BUILDING LEASE | 29167 |
| A/R DR. DENT | 1842 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1685342 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO RELATED ORGANIZATIONS | Description |
| Amount | $531,147 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 531147 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Allen S Weiss MD | |||||||||||||
| 0 | 598143 | 0 | 28868 | 0 | 16500 | 0 | 40671 | 0 | 14833 | 0 | 699015 | 0 | 0 |
| Kevin D Cooper | |||||||||||||
| 0 | 343159 | 0 | 15140 | 0 | 16500 | 0 | 9800 | 0 | 8313 | 0 | 392912 | 0 | 0 |
| Phillip Dutcher | |||||||||||||
| 0 | 361468 | 0 | 15140 | 0 | 0 | 0 | 9800 | 0 | 631 | 0 | 387039 | 0 | 0 |
| Aurora Estevez MD | |||||||||||||
| 0 | 360652 | 0 | 16994 | 0 | 16500 | 0 | 9800 | 0 | 8416 | 0 | 412362 | 0 | 0 |
| Vicki D Orr | |||||||||||||
| 0 | 337854 | 0 | 15140 | 0 | 16500 | 0 | 9800 | 0 | 21228 | 0 | 400522 | 0 | 0 |
| BRIAN SETTLE TERM 93011 | |||||||||||||
| 0 | 226108 | 0 | 11718 | 0 | 16500 | 0 | 9800 | 0 | 14172 | 0 | 278298 | 0 | 0 |
| SUSAN WOLFF TERM 93011 | |||||||||||||
| 0 | 232727 | 0 | 12184 | 0 | 16500 | 0 | 9800 | 0 | 8119 | 0 | 279330 | 0 | 0 |
| Michele Thoman | |||||||||||||
| 0 | 232585 | 0 | 10073 | 0 | 0 | 0 | 6743 | 0 | 15722 | 0 | 265123 | 0 | 0 |
| Michael Riley | |||||||||||||
| 0 | 189893 | 0 | 68 | 0 | 0 | 0 | 7753 | 0 | 21302 | 0 | 219016 | 0 | 0 |
| James K Martin | |||||||||||||
| 208452 | 0 | 90068 | 0 | 0 | 0 | 1177 | 0 | 12426 | 0 | 312123 | 0 | 0 | 0 |
| Kenneth Bookman MD | |||||||||||||
| 0 | 100723 | 0 | 40068 | 0 | 4125 | 0 | 4059 | 0 | 4820 | 0 | 153795 | 0 | 0 |
| Gary Parsons MD | |||||||||||||
| 0 | 69158 | 0 | 80068 | 0 | 4125 | 0 | 1467 | 0 | 1859 | 0 | 156677 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| COMPENSATION INFORMATION | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION FORM 990, SCHEDULE J, LINE 4B IN 1996, THE NCH HEALTHCARE SYSTEM, INC. BOARD OF TRUSTEES APPROVED A RECOMMENDATION OF THE EXECUTIVE COMPENSATION COMMITTEE THAT CERTAIN EXECUTIVES OF THE NCH HEALTHCARE SYSTEM WOULD BE PROVIDED WITH A SERP THAT WAS SUPPORTED THROUGH THE USE OF LIFE INSURANCE PROGRAMS. DUE TO CHANGES IN THE IRS TAX CODE, EFFECTIVE OCTOBER 1, 2003, THE FUNDING MECHANISM FOR ACTIVE EMPLOYEES WAS CHANGED FROM USING LIFE INSURANCE TO FUNDING RABBI TRUSTS. HOWEVER, THE PLAN DESIGN WAS NOT CHANGED. THE TRUST IS OWNED BY NCH AND IS SUBJECT TO THE RISK OF CREDITORS OF NCH. CONSEQUENTLY, DEPOSITS MADE TO THE TRUSTS REMAIN AS ASSETS OF NCH UNTIL THE PARTICIPANT VESTS IN ACCORDANCE WITH THE PLAN. THE SERP HAS BEEN DISCONTINUED WITH THE EXCEPTION OF DR. ALLEN WEISS, PRESIDENT & CEO, WHO IS NO LONGER RECEIVING CONTRIBUTIONS TO THE PLAN, BUT WHOSE PLAN CONTINUES TO REALIZE INVESTMENT INCOME/LOSSES ON PREVIOUS CONTRIBUTIONS WHICH HAVE BEEN REPORTED ON PRIOR YEAR FORMS 990. THE ACCOUNT OF ALLEN S. WEISS, M.D. REALIZED INVESTMENT INCOME OF $30,871 FOR THE CALENDAR YEAR 2010. THIS INVESTMENT INCOME IS INCLUDED IN SCHEDULE J, PART II, COLUMN C. PROVISION OF NON-FIXED PAYMENTS FORM 990, SCHEDULE J, LINE 7 THIS ORGANIZATION IS AN AFFILIATE OF NAPLES COMMUNITY HOSPITAL, INC. ("NCH"). ALL COMPENSATION ARRANGEMENTS ARE DETERMINED BY AND PAID THROUGH NCH. NCH MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE NCH COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. | |
| PROVISION OF HOUSING ALLOWANCE | HOUSING WAS PROVIDED FOR OUR CHIEF DEVELOPMENT OFFICER, JAMES MARTIN. THE VALUE OF SUCH HOUSING ($4,500) WAS INCLUDED AS A COMPONENT OF HIS REPORTABLE COMPENSATION LISTED ON FORM 990, PART VII. | FORM 990, SCHEDULE J, PART I, LINE 1A |
| DETAIL OF SEVERANCE PAYMENTS | WILLIAM EDWARDS, CHIEF ADMINISTRATIVE OFFICER, NCHMD, INC, RESIGNED 06/04/11 AND RECEIVED A SEVERANCE PAYMENT OF $146,505 FOR CALENDAR YEAR 2011. | FORM 990, SCHEDULE J, PART I, LINE 4A |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (43 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| SUPPLEMENTAL DISCLOSURES | BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 ALBERTO M. DE LA RIVAHERRERA, M.D. AND JOHN LEWIS, M.D. ARE MINORITY PARTNERS OF EMERGENCY PHYSICIANS OF NAPLES. REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11A INFORMATION RELATED TO NCH HEALTHCARE SYSTEM INC.'S ("NHSI") FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW AND RETURN PREPARATION. THE 2010 FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2011 WAS REVIEWED AND APPROVED BY THE CHAIRMAN OF THE NCH AUDIT AND FINANCE COMMITTEES, RESPECTIVELY, SENIOR LEADERSHIP TEAM AND OUTSIDE COUNSEL FOR THE BOARD PRIOR TO FILING WITH THE IRS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12 ANNUALLY, ALL NHSI OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. COMPENSATION PROCESS FORM 990, PART VI, SECTION B, LINE 15 THIS ORGANIZATION IS AN AFFILIATE OF NAPLES COMMUNITY HOSPITAL, INC. ("NCH"). ALL COMPENSATION ARRANGEMENTS ARE DETERMINED BY AND PAID THROUGH NCH. COMPENSATION ARRANGEMENTS INVOLVING OUR CEO and SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY NCH PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS). WRITTEN EMPLOYMENT CONTRACTS ARE ALSO UTILIZED. DOCUMENTS AVAILABILITY TO PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF NCH HEALTHCARE SYSTEM INC. ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE VIA OUR WEBSITE: WWW.NCHMD.ORG. DETAIL OF OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 THE AMOUNT REPRESENTS TRANSFERS WITH RELATED ORGANIZATIONS | |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Allen S. Weiss, M.D. TITLE:President/CEO/Trustee HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Terrance Flynn TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Kenneth Bookman, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Joann Jenner TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Frank Linsalata TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Robert Moses TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Gregory Wilkerson, RN TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Joseph I. Perkovich TITLE:Chairman HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Mariann MacDonald TITLE:1st Vice Chairman HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Ambassador Francis Rooney TITLE:Vice Chairman HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Thomas J. Gazdic TITLE:Secretary/Treasurer HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:William Allyn TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Jay H. Baker TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Susan L. Dalton TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Paul Dernbach, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Alberto M. de la Rivaherrera, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michael Feuer TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Daniel Gill TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Kay Gow TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Amy Jewell, RN TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Kim Ciccarelli Kantor TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Hermes Koop, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:John Lewis, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Admiral Paul D. Miller TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Wayne Mullican TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Karli Sander TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Scot C. Schultz, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Norman Thomson, M.D. TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Carl E. Westman TITLE:Trustee HOURS:2 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Kevin D. Cooper TITLE:General Counsel/Chief of Staff HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Phillip Dutcher TITLE:COO, NCH Healthcare System HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Aurora Estevez, M.D. TITLE:Chief Medical Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Vicki D. Orr TITLE:CFO/Assistant Treasurer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:BRIAN SETTLE TERM 9/30/11 TITLE:Chief Human Resources Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:SUSAN WOLFF TERM 9/30/11 TITLE:Chief Information Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michele Thoman TITLE:CNO HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michael Riley TITLE:Chief Strategy Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:James K. Martin TITLE:Chief Develop Officer HOURS:5 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:William Edwards (Term 06/4/11) TITLE:Chief Administrative Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Zach Bostock (Start 09/19/11) TITLE:Chief Administrative Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Gary Parsons, M.D. TITLE:Chief Medical Officer HOURS:44 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Elizabeth Martin TITLE:Assistant Secretary HOURS:44 | FORM 990 PART VII |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| MARCO ISLAND HOSPITAL INC | |||||||||
| 40 HEATHWOOD DRIVE | MARCO ISLAND | FL | 34145 | 592315435 | HEALTHCARE | FL | 501 (C)(3) | 3 | NCH SYSTEM |
| COLLIER HEALTH CARE INC | |||||||||
| PO BOX 413029 | NAPLES | FL | 34101 | 650244276 | HEALTHCARE | FL | 501 (C)(3) | 3 | NCH SYSTEM |
| NAPLES COMMUNITY HOSPITAL INC | |||||||||
| PO BOX 413029 | NAPLES | FL | 34101 | 590694358 | HEALTHCARE | FL | 501 (C)(3) | 3 | NCH SYSTEM |
| COMMUNITY HOME SERVICES INC | |||||||||
| PO BOX 413029 | NAPLES | FL | 34101 | 592440516 | SUPPORT ORG | FL | 501 (C)(3) | 11, B | NCH SYSTEM |
| NCHMD INC | |||||||||
| PO BOX 413029 | NAPLES | FL | 34101 | 331075317 | HEALTHCARE | FL | 501 (C)(3) | 9 | NCH SYSTEM |
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COUNSELING & EMPLOYEE ASSISTANCE PROGRAM | |||||||||||
| 350 7TH STREET NORTH | NAPLES | FL | 34102 | 650374989 | EMPLOYEE ASSIST | FL | NCH SYSTEM | C CORP | 0 | 0 | 1.00000 |
| HEALTH RESOURCES CORPORATION | |||||||||||
| 350 7TH STREET NORTH | NAPLES | FL | 34102 | 592568003 | HOLDING COMPANY | FL | NCH SYSTEM | C CORP | 510949 | 16490245 | 1.00000 |
| AMBULATORY SURGICAL CARE CENTER INC | |||||||||||
| 350 7TH STREET NORTH | NAPLES | FL | 34102 | 592568029 | OUTPAT. SURGERY | FL | HRC | C CORP | |||
| COMMUNITY HOME CARE INC | |||||||||||
| 350 7TH STREET NORTH | NAPLES | FL | 34102 | 592372966 | HOME HEALTH | FL | HRC | C CORP | |||
| COMMUNITY IMAGING INC | |||||||||||
| 350 7TH STREET NORTH | NAPLES | FL | 34102 | 592446336 | RADIOLOGY LAB | FL | HRC | C CORP | |||
| GULFCOAST LINEN SERVICE INC | |||||||||||
| 350 7TH STREET NORTH | NAPLES | FL | 34102 | 650214546 | LINEN SERVICE | FL | HRC | C CORP | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| COLLIER HEALTH CARE INC | |
| Q, R | 665567 |
| MARCO ISLAND HOSPITAL INC | |
| Q, R | 90238 |
| NAPLES COMMUNITY HOSPITAL INC | |
| Q, R | 3418571 |