TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) LEE ELMORE...................................................................... EXECUTIVE DI	50.00 .................	X		91,400
(2) REGINA M GAVLAK...................................................................... PRESIDENT/CE	50.00 .................	X	X	17,083
(3) JOHN GRIFFITHS...................................................................... CHAIR	.................	X	X	0
(4) KEITH VANDERBURG...................................................................... VICE CHAIR	.................	X	X	0
(5) JAY R CARSON ESQ...................................................................... SECRETARY	.................	X	X	0
(6) LAWRENCE E YUNASKA...................................................................... TREASURER	.................	X	X	0
(7) THOMAS GABLE...................................................................... DIRECTOR	.................	X		0
(8) TOM FRASER...................................................................... DIRECTOR	.................	X		0
(9) MICHAEL MITCHELL...................................................................... DIRECTOR	.................	X		0
(10) GEORGE W QUIL...................................................................... DIRECTOR	.................	X		0
(11) WENDY KIEDING...................................................................... DIRECTOR	.................	X		0
(12) MARK GETSAY...................................................................... DIRECTOR	.................	X		0
(13) REV DR JAMES C BUTLER...................................................................... DIRECTOR	.................	X		0
(14) NEIL P SMITH DO...................................................................... DIRECTOR	.................	X		0
(15) CHARLES GARVEN MD...................................................................... MEDICAL DIRE	.................	X		0
(16) CJ NOCK MD...................................................................... DIRECTOR	.................	X		0
(17) JOHN MEYERHOFFER...................................................................... DIRECTOR	.................	X		0

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) LEE ELMORE......................................................................
EXECUTIVE DI

50.00
.................

91,400

(2) REGINA M GAVLAK......................................................................
PRESIDENT/CE

50.00
.................

17,083

(3) JOHN GRIFFITHS......................................................................
CHAIR

.................

(4) KEITH VANDERBURG......................................................................
VICE CHAIR

.................

(5) JAY R CARSON ESQ......................................................................
SECRETARY

.................

(6) LAWRENCE E YUNASKA......................................................................
TREASURER

.................

(7) THOMAS GABLE......................................................................
DIRECTOR

.................

(8) TOM FRASER......................................................................
DIRECTOR

.................

(9) MICHAEL MITCHELL......................................................................
DIRECTOR

.................

(10) GEORGE W QUIL......................................................................
DIRECTOR

.................

(11) WENDY KIEDING......................................................................
DIRECTOR

.................

(12) MARK GETSAY......................................................................
DIRECTOR

.................

(13) REV DR JAMES C BUTLER......................................................................
DIRECTOR

.................

(14) NEIL P SMITH DO......................................................................
DIRECTOR

.................

(15) CHARLES GARVEN MD......................................................................
MEDICAL DIRE

.................

(16) CJ NOCK MD......................................................................
DIRECTOR

.................

(17) JOHN MEYERHOFFER......................................................................
DIRECTOR

.................

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(18) DAN SCALABRINO........................................................................
DIRECTOR

.......................

(19) ELLEN C OSPELT RN BS CDE........................................................................
DEVELOPMENT

.......................

(20) FRED DEGRANDIS........................................................................
DIRECTOR

.......................

(21) JANICE MURPHY........................................................................
DIRECTOR

.......................

(22) JOE STEWART........................................................................
DIRECTOR

.......................

(23) MILIJANA SUCEVIC BSN RN........................................................................
CLINICAL DIR

.......................

(24) LINDA STOKES PHD........................................................................
DIRECTOR

.......................

(25) ELIZABETH O'BRIEN........................................................................
EVENT DIRECT

.......................

(A)
Name and business address

(B)
Description of services

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

NORTH COAST HEALTH

Employer identification number

34-1536257

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	5,264,340	4,538,232	6,065,558	4,399,584	2,633,681	22,901,395
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......	6,621	4,021	1,144	107,006	154,936	273,728
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.	5,270,961	4,542,253	6,066,702	4,506,590	2,788,617	23,175,123
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)						23,175,123

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...	5,270,961	4,542,253	6,066,702	4,506,590	2,788,617	23,175,123
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	1,352	1,286	749	648	224	4,259
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	1,352	1,286	749	648	224	4,259
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..	5,272,313	4,543,539	6,067,451	4,507,238	2,788,841	23,179,382

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

99.980 %

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

99.950 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

0 %

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

0 %

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

NORTH COAST HEALTH

Employer identification number

34-1536257

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	39,000		39,000
b	Buildings
c	Leasehold improvements
d	Equipment ...
e	Other ...	782,959	380,493	402,466
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				441,466

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
LINE OF CREDIT	39,995
LEASE PAYABLE SHORT TERM	1,052
LEASE PAYABLE LONG TERM
SECURITY DEPOSIT
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	41,047
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1	2,788,841
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3	2,788,841
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	2,788,841

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	2,719,977
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3	2,719,977
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	2,719,977

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

NORTH COAST HEALTH

Employer identification number

34-1536257

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .	X	1	1,065,503
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )	X	2	276,701
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

NORTH COAST HEALTH

Employer identification number

34-1536257

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	NORTH COAST HEALTH (NCH), A FAITH BASED CHARITABLE CLINIC, IN COLLABORATION WITH COMMUNITY PARTNERS PROVIDES QUALITY HEALTH CARE AND OPTIMIZES ACCESS PREVENTION, WELLNESS AND EDUCATION. WE BELIEVE HEALTH CARE IS A BASIC HUMAN RIGHT AND THE INABILITY TO PAY SHOULD NEVER BE A BARRIER FOR ANYONE. NCH HAS RECEIVED THE HIGHEST LEVEL OF RECOGNITION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE AS A PATIENT CENTERED MEDICAL HOME (PCMH), LEVEL 3. AS A PCMH, PRIMARY CARE INCLUDING PREVENTION AND WELLNESS, CHRONIC DISEASE MANAGEMENT AND THE CARE OF MINOR ILLNESS AND INJURY WAS PROVIDED TO OVER 2,000 UNDUPLICATED PATIENTS IN 2015. OUR GOAL IS TO END HEALTH DISPARITIES AND INEQUITY BY PROVIDING ACCESS TO MEDICAL CARE THAT IS COMPARABLE TO THE CARE RECEIVED BY INDIVIDUALS OF HIGHER SOCIOECONOMIC STATUS. HEALTHCARE COVERAGE AND DELIVERY CONTINUES TO EVOLVE. NAVIGATING THIS SYSTEM IS COMPLICATED. NORTH COAST HEALTH REMAINS DILIGENT IN IDENTIFYING GAPS THAT HAVE CLOSED AS WELL AS NEW GAPS THAT HAVE OPENED AS A RESULT OF CHANGES IN THE HEALTHCARE DELIVERY SYSTEM. DESPITE IMPLEMENTATION OF THE AFFORDABLE CARE ACT AND MEDICAID EXPANSION, THE INDIVIDUALS WE SERVE CONTINUE TO HAVE UNMET NEEDS. PEOPLE STILL STRUGGLE WITH AFFORDABILITY OF CARE. FIFTY- FIVE PERCENT OF PATIENTS HAVE A HOUSEHOLD INCOME OF LESS THAN 15,000 ANNUALLY. MANY REMAIN UNINSURED AND OTHERS SIMPLY CANNOT AFFORD THE EXPENSIVE PREMIUMS AND DEDUCTIBLES WHICH CAN BE AS HIGH AS TWO THIRDS OF THEIR ANNUAL HOUSEHOLD INCOME. AS A SAFETY NET PROVIDER, NCH REMAINS POSITIONED TO HELP BRIDGE THE GAPS, EXPAND SERVICES, AND BE THE NEEDED MEDICAL HOME TO THE THOUSANDS OF INDIVIDUALS WHO COME TO US FOR CARE EACH YEAR.
FORM 990, PAGE 2, PART III, LINE 4D	FOR NEARLY 30 YEARS, NCH HAS WORKED TO MEET THE MEDICAL NEEDS OF THE ECONOMICALLY VULNERABLE AND MEDICALLY UNDERSERVED IN OUR COMMUNITY AND BEYOND. IN 2015, NORTH COAST HEALTH: SERVED 2,193 UNDUPLICATED PATIENTS, INCLUDING 822 NEW PATIENTS 49% UNINSURED AND 59% INSURED 81 % INSURED THROUGH MEDICAID, 8% MEDICARE AND 11% MARKETPLACE OR OTHER COVERAGE UNINSURED AND INSURED EXCEED 100% AS PATIENTS MOVE FROM HAVING INSURANCE AND BEING UNINSURED. WHEN THIS OCCURS, INDIVIDUALS ARE CAPTURED ONCE IN UNINSURED AND INSURED CATEGORY. PROVIDED 11,670 SERVICES INCLUDING- 4,739 PRIMARY CARE VISITS 2,216 SPECIALTY REFERRALS 313 BEHAVIORAL HEALTH COUNSELING VISITS AN ADDITIONAL 4,402 SERVICES WHICH INCLUDE NURSE VISITS, LABORATORY TESTING, ASSISTANCE WITH PRESCRIPTION ASSISTANCE FORMS, AND APPOINTMENTS FOR MARKETPLACE AND MEDICAID ENROLLMENT WERE PROVIDED. DISPENSED OVER 1 MILLION DOLLARS IN PRESCRIPTION MEDICATION TO UNINSURED INDIVIDUALS. WITH THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT, AND MEDICAID EXPANSION, NCH HAS SEEN A DECREASE IN THE AMOUNT OF DISPENSED PRESCRIPTION MEDICATIONS AS A RESULT OF MORE PATIENTS HAVING COVERAGE OF THEIR MEDICATIONS THROUGH INSURANCE. THIS HIGHLIGHTS AN IMPORTANT ROLE NCH HAS PLAYED - AND CONTINUES TO PLAY - AS A SAFETY NET PROVIDER; FILLING THE GAPS TO PROVIDE CARE AND MEDICATIONS UNTIL ADDITIONAL RESOURCES BECOME AFFORDABLE AND AVAILABLE. IN 2015, NORTH COAST HEALTH WAS RECOGNIZED AS A GOLD STAR PRACTICE BY BETTER HEALTH PARTNERSHIP, A REGIONAL HEALTH CARE IMPROVEMENT COLLABORATIVE, FOR OUTSTANDING IMPROVEMENT IN CARING FOR CHRONIC ILLNESS FOR DIABETES AND HYPERTENSION. NORTH COAST HEALTH IS MAKING A DIFFERENCE. OUR EFFORTS ARE HELPING TO IMPROVE HEALTH OUTCOMES; PREVENT DISEASE AND COMPLICATIONS, CONNECT PATIENTS TO OTHER COMMUNITY RESOURCES TO ASSIST WITH FOOD, HOUSING, UTILITIES, SUBSTANCE ABUSE AND OTHER NEEDS. WORKING TO END HEALTH DISPARITIES BY PROVIDING THE UNDERSERVED QUALITY, COMPREHENSIVE AND COORDINATED HEALTH CARE NOT ONLY BENEFITS THE INDIVIDUAL BUT ALSO THEIR FAMILY, EMPLOYERS, THE HEALTHCARE SYSTEM AND TAXPAYERS. THESE EFFORTS REDUCE HEALTH CARE COSTS AND IMPROVE THE HEALTH OF OUR COMMUNITY AND WORKFORCE. PRIMARY CARE SERVICES ARE PROVIDED FIVE DAYS PER WEEK, WITH EVENING AND WEEKEND HOURS AVAILABLE. A TRIPLE AIM APPROACH OF BETTER HEALTH-BETTER CARE-LOWER COST IS USED TO ENSURE THE RIGHT PATIENT RECEIVES THE RIGHT CARE AT THE RIGHT PLACE AND TIME. SERVICES INCLUDE: 1) CHRONIC DISEASE MANAGEMENT- INDIVIDUALIZED CARE TO MEET EACH PATIENT'S UNIQUE NEEDS. INCREASED UNDERSTANDING OF CONDITIONS AND PATIENT ENGAGEMENT, IMPROVED HEALTH STATUS AND PREVENTION OF COMPLICATIONS. 2) WOMEN'S HEALTH - PREVENTIVE BREAST HEALTH AND GYNECOLOGICAL SCREENINGS AND CARE. 3) PRESCRIPTION ASSISTANCE PROGRAM - FREE, OR LOW COST, MEDICATIONS TO MANAGE CHRONIC DISEASE AND ACUTE CONDITIONS; INCLUDES IMMUNIZATIONS AND HOME HEALTH SUPPLIES. 4) SPECIALTY REFERRALS - SPECIALTY CARE DONATED BY VOLUNTEER REFERRAL PHYSICIAN NETWORK AND THROUGH CUYAHOGA HEALTH ACCESS PARTNERSHIP (CHAP). 5) BEHAVIORAL HEALTH COUNSELING - ONSITE COUNSELING SERVICES, INDIVIDUAL AND GROUP FOR PATIENTS WITH DEPRESSION AND OTHER MENTAL HEALTH DISORDERS. 6) PATIENT CRITICAL NEEDS ASSISTANCE (PCNA) - SUPPORTS SHORT TERM CRITICAL NEEDS FOR GROCERIES, TRANSPORTATION, MEDICAL SUPPLIES (I.E. NEBULIZERS, ORTHOPEDIC EQUIPMENT INCLUDING BRACES, PROSTHETICS, WALKERS, WHEELCHAIRS, SUPPORT STOCKINGS/SOCKS, AND DIABETES TESTING SUPPLIES), TRANSLATION SERVICES AND PRESCRIPTION MEDICATIONS. 7) ONSITE LABORATORY AND MEDICAL TESTING - POINT OF CARE LABORATORY AND MEDICAL TESTING, ALLOWING FOR IMMEDIATE RESULTS AND AN OPPORTUNITY TO REVIEW, ADDRESS, MANAGE AND EDUCATE PATIENTS ON DISEASE MANAGEMENT AND PREVENTION DURING CLINIC VISIT. 8) CERTIFIED APPLICATION COUNSELORS/NAVIGATOR - ASSIST IN ENROLLING INDIVIDUALS- NCH PATIENTS AND OTHERS- INTO MEDICAID, MARKETPLACE, BENEFITS BANK AND OTHER PROGRAMS. 9)PREVENT BLINDNESS - REFERRAL FOR FREE/REDUCED COST EYE EXAMS, GLASSES. 10) SMOKING CESSATION- GROUP AND INDIVIDUAL COUNSELING ON SMOKING CESSATION AND PREVENTION. 11) CREATIVE ARTS THERAPY SCHOLARSHIP PROGRAM (CATS) - CREATIVE ARTS INTERVENTION IN SUPPORT OF PATIENT HEALTH AND WELL-BEING. PROGRAMS WITH ART THERAPY STUDIO AND BECK CENTER. 12) WORKFORCE DEVELOPMENT - CLINICAL SITE FOR NURSING, NURSE PRACTITIONER, MEDICAL STUDENTS, RESIDENTS, AND HIGH SCHOOL STUDENTS FROM WESTSHORE CAREER TECH. 13) COMMUNITY OUTREACH - OUTREACH AND HEALTH EDUCATION TO SCHOOLS, COMMUNITY, AND OTHER SOCIAL SERVICE NETWORKS. PARTICIPATION AND LEADERSHIP ROLES IN AREA COMMUNITY COLLABORATIVE.
FORM 990, PAGE 6, PART VI, LINE 11B	COPY OF COMPLETE 990 E-MAILED TO TRUSTEES FOR REVIEW PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12C	THE CONFLICT OF INTEREST DISCLOSURE STATEMENT IS DISTRIBUTED ANNUALLY TO EACH BOARD MEMBER FOR SIGNATURE. THE STATEMENTS ARE KEPT ON FILE AT THE OFFICES OF NORTH COAST HEALTH MINISTRY.
FORM 990, PAGE 6, PART VI, LINE 15A	EXECUTIVE COMMITTEE RECOMMENDS SALARY OF THE EXECUTIVE DIRECTOR DURING AN EXECUTIVE SESSION OF THE ANNUAL MEETING OF THE BOARD. SALARY COMPARABILITY DATA IS COLLECTED FROM APPROPRIATE SOURCES FOR THE BOARD'S REVIEW.
FORM 990, PAGE 6, PART VI, LINE 15B	ANNUAL STAFF REVIEWS ARE CONDUCTED BY IMMEDIATE SUPERVISOR AND EXECUTIVE DIRECTOR. THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR SUBMITS STAFF SALARY RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE FOR REVIEW AND APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 19	DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: NORTH COAST HEALTH (NCH), A FAITH BASED CHARITABLE CLINIC, IN COLLABORATION WITH COMMUNITY PARTNERS PROVIDES QUALITY HEALTH CARE AND OPTIMIZES ACCESS PREVENTION, WELLNESS AND EDUCATION. WE BELIEVE HEALTH CARE IS A BASIC HUMAN RIGHT AND THE INABILITY TO PAY SHOULD NEVER BE A BARRIER FOR ANYONE. NCH HAS RECEIVED THE HIGHEST LEVEL OF RECOGNITION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE AS A PATIENT CENTERED MEDICAL HOME (PCMH), LEVEL 3. AS A PCMH, PRIMARY CARE INCLUDING PREVENTION AND WELLNESS, CHRONIC DISEASE MANAGEMENT AND THE CARE OF MINOR ILLNESS AND INJURY WAS PROVIDED TO OVER 2,000 UNDUPLICATED PATIENTS IN 2015. OUR GOAL IS TO END HEALTH DISPARITIES AND INEQUITY BY PROVIDING ACCESS TO MEDICAL CARE THAT IS COMPARABLE TO THE CARE RECEIVED BY INDIVIDUALS OF HIGHER SOCIOECONOMIC STATUS. HEALTHCARE COVERAGE AND DELIVERY CONTINUES TO EVOLVE. NAVIGATING THIS SYSTEM IS COMPLICATED. NORTH COAST HEALTH REMAINS DILIGENT IN IDENTIFYING GAPS THAT HAVE CLOSED AS WELL AS NEW GAPS THAT HAVE
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	21
6	Total number of volunteers (estimate if necessary) .............	6	60
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,399,584	2,633,681
9	Program service revenue (Part VIII, line 2g) .........	107,006	154,936
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	648	224
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)		0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	4,507,238	2,788,841
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	882,775	919,104
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 150,811
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	3,773,006	1,800,873
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	4,655,781	2,719,977
19	Revenue less expenses. Subtract line 18 from line 12.......	-148,543	68,864
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,193,501	1,148,677
21	Total liabilities (Part X, line 26).............	373,536	259,848
22	Net assets or fund balances. Subtract line 21 from line 20.....	819,965	888,829

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 37,412 including grants of $ ) (Revenue $ )
	NORTH COAST HEALTH EXISTS TO STRENGTHEN THE QUALITY OF COMMUNITY LIFE THROUGH THE PROVISION OF HEALTH CARE SERVICES FOR THE MOST ECONOMICALLY VULNERABLE IN OUR COMMUNITY. THIS COMMITMENT IS FULFILLED BY PROVIDING MEDICAL SERVICES INCLUDING DIAGNOSIS, TREATMENT AND REFERRAL, PRESCRIPTION ASSISTANCE, COOPERATING WITH OTHER HEALTH AND HUMAN SERVICE ORGANIZATIONS AND SEEKING ADDITIONAL OPPORTUNITIES TO SERVE INDIVIDUALS IN NEED.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












	(Code: ) (Expenses $ 2,429,889 including grants of $ ) (Revenue $ )
	FOR NEARLY 30 YEARS, NCH HAS WORKED TO MEET THE MEDICAL NEEDS OF THE ECONOMICALLY VULNERABLE AND MEDICALLY UNDERSERVED IN OUR COMMUNITY AND BEYOND. IN 2015, NORTH COAST HEALTH: SERVED 2,193 UNDUPLICATED PATIENTS, INCLUDING 822 NEW PATIENTS 49% UNINSURED AND 59% INSURED 81 % INSURED THROUGH MEDICAID, 8% MEDICARE AND 11% MARKETPLACE OR OTHER COVERAGE UNINSURED AND INSURED EXCEED 100% AS PATIENTS MOVE FROM HAVING INSURANCE AND BEING UNINSURED. WHEN THIS OCCURS, INDIVIDUALS ARE CAPTURED ONCE IN UNINSURED AND INSURED CATEGORY. PROVIDED 11,670 SERVICES INCLUDING- 4,739 PRIMARY CARE VISITS 2,216 SPECIALTY REFERRALS 313 BEHAVIORAL HEALTH COUNSELING VISITS AN ADDITIONAL 4,402 SERVICES WHICH INCLUDE NURSE VISITS, LABORATORY TESTING, ASSISTANCE WITH PRESCRIPTION ASSISTANCE FORMS, AND APPOINTMENTS FOR MARKETPLACE AND MEDICAID ENROLLMENT WERE PROVIDED. DISPENSED OVER 1 MILLION DOLLARS IN PRESCRIPTION MEDICATION TO UNINSURED INDIVIDUALS. WITH THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT, AND MEDICAID EXPANSION, NCH HAS SEEN A DECREASE IN THE AMOUNT OF DISPENSED PRESCRIPTION MEDICATIONS AS A RESULT OF MORE PATIENTS HAVING COVERAGE OF THEIR MEDICATIONS THROUGH INSURANCE. THIS HIGHLIGHTS AN IMPORTANT ROLE NCH HAS PLAYED - AND CONTINUES TO PLAY - AS A SAFETY NET PROVIDER; FILLING THE GAPS TO PROVIDE CARE AND MEDICATIONS UNTIL ADDITIONAL RESOURCES BECOME AFFORDABLE AND AVAILABLE. IN 2015, NORTH COAST HEALTH WAS RECOGNIZED AS A GOLD STAR PRACTICE BY BETTER HEALTH PARTNERSHIP, A REGIONAL HEALTH CARE IMPROVEMENT COLLABORATIVE, FOR OUTSTANDING IMPROVEMENT IN CARING FOR CHRONIC ILLNESS FOR DIABETES AND HYPERTENSION. NORTH COAST HEALTH IS MAKING A DIFFERENCE. OUR EFFORTS ARE HELPING TO IMPROVE HEALTH OUTCOMES; PREVENT DISEASE AND COMPLICATIONS, CONNECT PATIENTS TO OTHER COMMUNITY RESOURCES TO ASSIST WITH FOOD, HOUSING, UTILITIES, SUBSTANCE ABUSE AND OTHER NEEDS. WORKING TO END HEALTH DISPARITIES BY PROVIDING THE UNDERSERVED QUALITY, COMPREHENSIVE AND COORDINATED HEALTH CARE NOT ONLY BENEFITS THE INDIVIDUAL BUT ALSO THEIR FAMILY, EMPLOYERS, THE HEALTHCARE SYSTEM AND TAXPAYERS. THESE EFFORTS REDUCE HEALTH CARE COSTS AND IMPROVE THE HEALTH OF OUR COMMUNITY AND WORKFORCE. PRIMARY CARE SERVICES ARE PROVIDED FIVE DAYS PER WEEK, WITH EVENING AND WEEKEND HOURS AVAILABLE. A TRIPLE AIM APPROACH OF BETTER HEALTH-BETTER CARE-LOWER COST IS USED TO ENSURE THE RIGHT PATIENT RECEIVES THE RIGHT CARE AT THE RIGHT PLACE AND TIME. SERVICES INCLUDE: 1) CHRONIC DISEASE MANAGEMENT- INDIVIDUALIZED CARE TO MEET EACH PATIENT'S UNIQUE NEEDS. INCREASED UNDERSTANDING OF CONDITIONS AND PATIENT ENGAGEMENT, IMPROVED HEALTH STATUS AND PREVENTION OF COMPLICATIONS. 2) WOMEN'S HEALTH - PREVENTIVE BREAST HEALTH AND GYNECOLOGICAL SCREENINGS AND CARE. 3) PRESCRIPTION ASSISTANCE PROGRAM - FREE, OR LOW COST, MEDICATIONS TO MANAGE CHRONIC DISEASE AND ACUTE CONDITIONS; INCLUDES IMMUNIZATIONS AND HOME HEALTH SUPPLIES. 4) SPECIALTY REFERRALS - SPECIALTY CARE DONATED BY VOLUNTEER REFERRAL PHYSICIAN NETWORK AND THROUGH CUYAHOGA HEALTH ACCESS PARTNERSHIP (CHAP). 5) BEHAVIORAL HEALTH COUNSELING - ONSITE COUNSELING SERVICES, INDIVIDUAL AND GROUP FOR PATIENTS WITH DEPRESSION AND OTHER MENTAL HEALTH DISORDERS. 6) PATIENT CRITICAL NEEDS ASSISTANCE (PCNA) - SUPPORTS SHORT TERM CRITICAL NEEDS FOR GROCERIES, TRANSPORTATION, MEDICAL SUPPLIES (I.E. NEBULIZERS, ORTHOPEDIC EQUIPMENT INCLUDING BRACES, PROSTHETICS, WALKERS, WHEELCHAIRS, SUPPORT STOCKINGS/SOCKS, AND DIABETES TESTING SUPPLIES), TRANSLATION SERVICES AND PRESCRIPTION MEDICATIONS. 7) ONSITE LABORATORY AND MEDICAL TESTING - POINT OF CARE LABORATORY AND MEDICAL TESTING, ALLOWING FOR IMMEDIATE RESULTS AND AN OPPORTUNITY TO REVIEW, ADDRESS, MANAGE AND EDUCATE PATIENTS ON DISEASE MANAGEMENT AND PREVENTION DURING CLINIC VISIT. 8) CERTIFIED APPLICATION COUNSELORS/NAVIGATOR - ASSIST IN ENROLLING INDIVIDUALS- NCH PATIENTS AND OTHERS- INTO MEDICAID, MARKETPLACE, BENEFITS BANK AND OTHER PROGRAMS. 9)PREVENT BLINDNESS - REFERRAL FOR FREE/REDUCED COST EYE EXAMS, GLASSES. 10) SMOKING CESSATION- GROUP AND INDIVIDUAL COUNSELING ON SMOKING CESSATION AND PREVENTION. 11) CREATIVE ARTS THERAPY SCHOLARSHIP PROGRAM (CATS) - CREATIVE ARTS INTERVENTION IN SUPPORT OF PATIENT HEALTH AND WELL-BEING. PROGRAMS WITH ART THERAPY STUDIO AND BECK CENTER. 12) WORKFORCE DEVELOPMENT - CLINICAL SITE FOR NURSING, NURSE PRACTITIONER, MEDICAL STUDENTS, RESIDENTS, AND HIGH SCHOOL STUDENTS FROM WESTSHORE CAREER TECH. 13) COMMUNITY OUTREACH - OUTREACH AND HEALTH EDUCATION TO SCHOOLS, COMMUNITY, AND OTHER SOCIAL SERVICE NETWORKS. PARTICIPATION AND LEADERSHIP ROLES IN AREA COMMUNITY COLLABORATIVE.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 2,429,889 including grants of $ ) (Revenue $ )
4e	Total program service expenses2,467,301

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	108,483

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	116,394

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,517,287

g	Noncash contributions included in lines 1a-1f:$ 1,342,204
h Total.Add lines 1a-1f.......		2,633,681

		Business Code
2a	INSURANCE PAYMENTS	130,935	130,935
b	INSURED PATIENTS	14,892	14,892
c	UNINSURED	8,884	8,884
d	PATIENT DONATIONS	225	225
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....		154,936

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			224			224
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			2,788,841	154,936		224

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	108,483	37,969	27,121	43,393
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	718,907	653,516	16,513	48,878
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	46,481	37,412	2,912	6,157
10	Payroll taxes ...........	45,233	36,408	2,833	5,992
11	Fees for services (non-employees):
a	Management ......	15,600		15,600
b	Legal .........
c	Accounting ...........	9,250		9,250
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	17,471		17,471
12	Advertising and promotion ....	27,520			27,520
13	Office expenses .......	30,710	26,876		3,834
14	Information technology ......	65,358	62,339		3,019
15	Royalties ..
16	Occupancy ...........	52,133	52,133
17	Travel ............	5,692	5,692
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	39,774	39,774
23	Insurance ...	26,219	26,219
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PRESCRIPTIONS & PHYSICIAN	1,027,332	1,027,332
b	BAD DEBT EXPENSE	268,528	268,528
c	TEMPORARY LABOR	123,834	123,834
d	CLINIC SUPPLIES	26,841	26,841
e	All other expenses	64,611	42,428	10,165	12,018
25	Total functional expenses. Add lines 1 through 24e	2,719,977	2,467,301	101,865	150,811
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			48,497	1	40,398
2	Savings and temporary cash investments .........			175,539	2	97,649
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			99,208	4	109,283
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			391,876	8	449,482
9	Prepaid expenses and deferred charges ......			7,231	9	9,299
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	821,959
b	Less: accumulated depreciation	10b	380,493	470,050	10c	441,466
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,100	15	1,100
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,193,501	16	1,148,677

17	Accounts payable and accrued expenses .....	27,049	17	14,163
18	Grants payable ...		18
19	Deferred revenue .........	339,123	19	204,638
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	7,364	25	41,047
26	Total liabilities. Add lines 17 through 25..	373,536	26	259,848

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	819,965	27	888,829
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	819,965	33	888,829
34	Total liabilities and net assets/fund balances ........	1,193,501	34	1,148,677