BLACK HILLS CENTER FOR AMERICAN INDIAN HEALTH: Form 990, tax year 2011
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- Organization
- BLACK HILLS CENTER FOR AMERICAN INDIAN HEALTH (EIN 46-0451715)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-09-25
- IRS object ID
- 201232699349300028
- Schema version
- 2011v1.2
- 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 | 2012-09-25T17:34:39-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460403496 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASEY PETERSON & ASSOC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST SUITE 101 | AddressLine1 |
| City | RAPID CITY | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460451715 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLACK HILLS CENTER FOR AMERICAN INDIAN HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BLAC | NameControl |
| Phone | 6053486100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 ST JOSEPH STREET SUITE 204 | AddressLine1 |
| City | RAPID CITY | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DR JEFFREY HENDERSON | Name |
| Title | PRESIDENT | Title |
| Phone | 6053486100 | Phone |
| Date Signed | 2012-09-25 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEIDRE BUDAHL CPA | Name |
| PTIN | P01273830 | PTIN |
| Phone | 6053481930 | Phone |
| Date Prepared | 2012-09-25 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DR JEFFREY HENDERSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 ST JOSEPH STREET SUITE 204 | AddressLine1 |
| City | RAPID CITY | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1714731 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BHCAIH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1998 | YearFormation |
| State Legal Domicile | SD | StateLegalDomicile |
| Activity Or Mission Description | TO CONDUCT RESEARCH FOR NATIVE AMERICAN HEALTH STUDIES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 4 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 14 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1694261 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1710864 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3858 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3867 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1698119 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1714731 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 315370 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 196090 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1053814 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1003358 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 357459 | OtherExpensePriorYear |
| Other Expenses Current Year | 580788 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1726643 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1780236 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -28524 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -65505 | RevenuesLessExpensesCY |
| Total Assets BOY | 529006 | TotalAssetsBOY |
| Total Assets EOY | 412640 | TotalAssetsEOY |
| Total Liabilities BOY | 187507 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 136646 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 341499 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 275994 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE ORGANIZATION WAS FORMED TO CONDUCT A WIDE RANGE OF ACTIVITIES INTENDED TO ENHANCE THE PHYSICAL, MENTAL, SPIRITUAL, AND CULTURAL HEALTH OF AMERICAN INDIANS, WITH AN EMPHASIS ON THOSE TRIBES OF THE NORTHERN PLAINS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1489739 | Expense |
| Grants | 491912 | Grants |
| Description | HEALTH RELATED RESEARCH FOR THE BENEFIT OF AMERICAN INDIANS PRIMARILY FOR THE BENEFIT OF THE TRIBES OF THE NORTHERN PLAINS | Description |
| Total Program Service Expense | 1489739 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 13 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 14 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 4 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6053486100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 ST JOSEPH ST | AddressLine1 |
| City | RAPID CITY | City |
| State | SD | State |
| ZIP Code | 57701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (4 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JEFFREY A HENDERSON | ||||||
| PRESIDENT & CEO | 40.00 | X | X | 197630 | 0 | 10664 |
| PATRICIA NEZ HENDERSON | ||||||
| ASSISTANT VICE PRESIDENT | 40.00 | X | X | 144773 | 0 | 8936 |
| GAY KINGMAN | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| ARTHUR W ZIMIGA | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 342403 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 19600 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MISSOURI BREAKS | |||||
| HCR 64 BOX 52 | TIMBERLAKE | SD | 57656 | RESEARCH UNDER GRANTS | 259247 |
| UNIVERSITY OF WASHINGTON | |||||
| 12455 COLLECTIONS DR | CHICAGO | IL | 60698 | RESEARCH UNDER GRANTS | 112494 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 1560022 | GovernmentGrants |
| All Other Contributions | 150842 | AllOtherContributions |
| Total Contributions | 1710864 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3867 | TotalRevenueColumn |
| Exclusion | $3,867 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1714731 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $3,867 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196090 | Total |
| Program Services | 196090 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362003 | Total |
| Program Services | 209643 | ProgramServices |
| Management And General | 152360 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393855 | Total |
| Program Services | 321061 | ProgramServices |
| Management And General | 72794 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204047 | Total |
| Program Services | 187126 | ProgramServices |
| Management And General | 16921 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43453 | Total |
| Program Services | 43453 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9922 | Total |
| Management And General | 9922 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70421 | Total |
| Program Services | 70421 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9966 | Total |
| Program Services | 9966 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72011 | Total |
| Program Services | 54301 | ProgramServices |
| Management And General | 17710 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68283 | Total |
| Program Services | 54447 | ProgramServices |
| Management And General | 13836 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60188 | Total |
| Program Services | 57313 | ProgramServices |
| Management And General | 2875 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 153 | Total |
| Management And General | 153 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18568 | Total |
| Program Services | 14642 | ProgramServices |
| Management And General | 3926 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RESEARCH | Description |
| Total | 271276 | Total |
| Program Services | 271276 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1780236 | Total |
| Program Services | 1489739 | ProgramServices |
| Management And General | 290497 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 196696 | BOY |
| EOY | 169677 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15000 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 276874 | BOY |
| EOY | 214238 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 1325 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4346 | BOY |
| EOY | 6558 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 335898 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 315056 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36090 | BOY |
| EOY | 20842 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 529006 | BOY |
| EOY | 412640 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77816 | BOY |
| EOY | 126646 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109691 | BOY |
| EOY | 10000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187507 | BOY |
| EOY | 136646 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224122 | BOY |
| EOY | 194608 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117377 | BOY |
| EOY | 81386 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 341499 | BOY |
| EOY | 275994 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 529006 | BOY |
| EOY | 412640 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -65505 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1932543 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1717763 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2031508 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1694261 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1666081 | CurrentTaxYear |
| Total | 9042156 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1932543 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1717763 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2031508 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1694261 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1666081 | CurrentTaxYear |
| Total | 9042156 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 9042156 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2464 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 280 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3959 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5217 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3867 | CurrentTaxYear |
| Total | 15787 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 9057943 | TotalSupport |
| Gross Receipts From Admissions Etc | 44783 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99830 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99870 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 335898 | OtherCostOrOtherBasis |
| Depreciation | 315056 | Depreciation |
| Book Value | 20842 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20842 | TotalOfBookValueLandBuildings |
| Total Revenue | 1714731 | TotalRevenue |
| Total Expenses | 1780236 | TotalExpenses |
| Excess Or Deficit For Year | -65505 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -65505 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1714731 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 1714731 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 1714731 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1780236 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 1780236 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 1780236 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT LIABLE FOR INCOME TAXES IF IT OPERATES WITHIN THE CONFINES OF ITS EXEMPT STATUS, THOUGH THE ORGANIZATION MAY BE RESPONSIBLE FOR TAXES ON UNRELATED BUSINESS ACTIVITIES. IN THE EVENT OF AN EXAMINATION OF THE INCOME TAX RETURNS, THE TAX LIABILITY OF THE ORGANIZATION COULD BE CHANGED IF AN ADJUSTMENT IN THE TAX EXEMPT PURPOSE OR INCOME FROM UNRELATED BUSINESS ACTIVITIES IS ULTIMATELY DETERMINED BY THE TAXING AUTHORITIES. AS OF DECEMBER 31, 2011, THE COMPANY HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE COMPANY'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE COMPANY IS NO LONGER SUBJECT TO FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2008. MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATION, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE COMPANY BELIEVES THEIR ESTIMATES ARE APPROPRIATE BASED ON CURRENT FACTS AND CIRCUMSTANCES. INTEREST AND PENALTIES ASSESSED BY INCOME TAXING AUTHORITIES, IF ANY, ARE INCLUDED IN INTEREST EXPENSE. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| GROUP HEALTH COOPERATIVE | |||||||
| 1730 MINOR AVE | SEATTLE | WA | 98101 | 910511770 | 501(C)(3) | 13013 | COMPILE RESEARCH DATA OBTAINED DURING RESEARCH STUDIES |
| UNIVERSITY OF WASHINGTON GRANT & CONTRACT | |||||||
| 12455 COLLECTIONS DRIVE | CHICAGO | IL | 60693 | 916001537 | STATE OF WASHINGTON | 112494 | COMPILE RESEARCH DATA OBTAINED DURING RESEARCH STUDIES |
| MEDSTAR RESEARCH INSTITUTE | |||||||
| PO BOX 418223 | BOSTON | MA | 02241 | 526056274 | 501(C)(3) | 38749 | COMPILE RESEARCH DATA OBTAINED DURING RESEARCH STUDIES |
| UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER | |||||||
| PO BOX 4390 | HOUSTON | TX | 77210 | 746001118 | STATE OF TEXAS | 14434 | COMPILE RESEARCH DATA OBTAINED DURING RESEARCH STUDIES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE ORGANIZATION REQUIRES QUARTERLY AND YEAR END REPORTS FROM EACH SUBRECIPIENT. THE ORGANIZATION REVIEWS THESE REPORTS AGAINST THE CRITERIA USED TO AWARD THE GRANT/PAYMENT FOR COMPLIANCE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JEFFREY A HENDERSON | NamePerson |
| Base Compensation Filing Org | 197630 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 197630 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| DR JEFFREY HENDERSON | |||
| BOARD MEMBER AND EMPLOYEE | 208294 | WAGES AND OTHER COMPENSATION PAID TO INDIVIDUAL | 0 |
| DR PATRICIA HENDERSON | |||
| BOARD MEMBER AND EMPLOYEE | 153709 | WAGES AND OTHER COMPENSATION PAID TO INDIVIDUAL | 0 |
| PETER F NEZ | |||
| FAMILY MEMBER OF BOARD MEMBER | 56694 | WAGES AND OTHER COMPENSATION | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | TWO OF THE FOUR DIRECTORS ARE MARRIED TO EACH OTHER. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED AND SIGNED BY THE PRESIDENT OF THE ORGANIZATION, WHO ALSO SERVES AS A DIRECTOR FOR THE ORGANIZATION. ALL BOARD MEMBERS WERE GIVEN A COPY OF THE 990 TO REVIEW BEFORE IT WAS FINALIZED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A FORMAL POLICY, HOWEVER AT THIS TIME THE BOARD AND KEY EMPLOYEES ARE THE SAME PERSONS AND ARE OF LIMITED SIZE THEREFORE MONITORING IS SIMPLIFIED. THE BOARD DOES LOOK AT POTENTIAL CONFLICTS WHEN EMPLOYEES ARE HIRED. |
| FORM 990, PART VI, SECTION B, LINE 15 | WAGES FOR THE CEO, WHO ALSO SERVES AS A PRINCIPAL INVESTIGATOR FOR SEVERAL GRANTS, IS DETERMINED BASED ON A REVIEW OF THE MAXIMUM ALLOWABLE WAGES FOR PRINCIPAL INVESTIGATORS BY THE NATIONAL INSTITUTE OF HEALTH FOR GRANTS. WAGES ARE ALSO COMPARED TO PAY SCALES FOR SIMILAR POSITIONS IN ACEDEMIA AND THE PRIVATE SECTOR AND ARE DETERMINED BASED ON EACH PERSON'S DEGREE AND EXPERIENCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990 PART XI, LINE 2C. | THE BOARD IS RESPONSIBLE FOR PROVIDING OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. |